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Vere M, ten Ham-Baloyi W, Melariri PE. Effects of paediatric schistosomiasis control programmes in sub-Saharan Africa: A systematic review. PLoS One 2024; 19:e0301464. [PMID: 38696510 PMCID: PMC11065241 DOI: 10.1371/journal.pone.0301464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 03/17/2024] [Indexed: 05/04/2024] Open
Abstract
Preventive chemotherapy by mass drug administration is globally recommended as the primary method of reaching the elimination of schistosomiasis, especially in the high risk-paediatric population. This systematic review provides a summary of the effects of paediatric schistosomiasis control programs on eliminating schistosomiasis in sub-Saharan Africa. A systematic search was conducted in PubMed, EBSCOhost, and other databases to obtain studies regarding the effects of paediatric schistosomiasis control programmes in sub-Saharan Africa. 3455 studies were screened for eligibility, included articles reported on both paediatrics control programmes and schistosomiasis, and articles were excluded when they did not report on schistosomiasis control programmes in paediatrics exclusively. 40 selected studies were critically appraised using the JBI critical appraisal tools for relevance and 30 studies were included in the study. An in-depth quantitative descriptive analysis was conducted, and a comprehensive narrative summary explained the results within the scope of the review questions. The results show that despite preventive chemotherapy lowering schistosomiasis prevalence, chances of re-infection are high in endemic areas. Preventive chemotherapy without complementary interventions including safe water provision and proper sanitation, snail control and health education on the aetiology of schistosomiasis, transmission pattern and control practices might not eliminate schistosomiasis.
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Affiliation(s)
- Maryline Vere
- Faculty of Health Sciences, Department of Environmental Health, Nelson Mandela University, University Way, Summerstrand, Gqeberha, South Africa
| | - Wilma ten Ham-Baloyi
- Faculty of Health Sciences, Department of Environmental Health, Nelson Mandela University, University Way, Summerstrand, Gqeberha, South Africa
- Faculty of Health Sciences, Department of Nursing Science, Nelson Mandela University, University Way, Summerstrand, Gqeberha, South Africa
| | - Paula Ezinne Melariri
- Faculty of Health Sciences, Department of Nursing Science, Nelson Mandela University, University Way, Summerstrand, Gqeberha, South Africa
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Gebreegziabher T, Sidibe S. Prevalence and contributing factors of anaemia among children aged 6-24 months and 25-59 months in Mali. J Nutr Sci 2023; 12:e112. [PMID: 37964977 PMCID: PMC10641697 DOI: 10.1017/jns.2023.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/18/2023] [Accepted: 10/06/2023] [Indexed: 11/16/2023] Open
Abstract
Although considerable global initiatives have been undertaken to tackle anaemia, its prevalence continues to be high in sub-Saharan African nations. In Mali specifically, anaemia represents a significant and pressing public health issue. The purpose of the present study was to examine the key risk factors related to anaemia among children aged 6-24 months (younger age group) and 25-59 months (older age group). We used the Mali 2018 Demographic and Health Survey data, collected from 8861 mothers with children under five. Logistic regression was used to assess the risk factors for childhood anaemia. The results suggest that the prevalence of anaemia was 88 % in the younger and 76 % in the older age groups. The risk factors unique to the younger age group were malaria (OR 4⋅05; CI 0⋅95, 11⋅3) and place of residence (OR 0⋅55; CI 0⋅32, 0⋅94), while for the older age group, they were morbidity (OR 1⋅91; CI 1⋅12, 3⋅24), drinking from a bottle (OR 1⋅52; CI 1⋅04, 2⋅22), and micronutrient intake (OR 0⋅61; CI 0⋅40, 0⋅91). Risk factors that significantly contributed to both age groups include breastfeeding, deworming, maternal anaemia, maternal education, and wealth index. Anaemia also varied by region. The widespread prevalence of anaemia can be attributed to a multitude of factors. In addressing this issue, it is imperative to acknowledge the unique characteristics of specific regions and rural areas, where the incidence of anaemia surpasses the national average. Therefore, any intervention efforts should be tailored to the specific needs and challenges of these areas.
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Affiliation(s)
- Tafere Gebreegziabher
- Food Science and Nutrition, Department of Health Sciences, Central Washington University, 400 E University Way, Ellensburg, WA 98926-7571, USA
| | - Saran Sidibe
- Food Science and Nutrition, Department of Health Sciences, Central Washington University, 400 E University Way, Ellensburg, WA 98926-7571, USA
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Neto AFR, Di Christine Oliveira YL, de Oliveira LM, La Corte R, Jain S, de Lyra Junior DP, Fujiwara RT, Dolabella SS. Why Are We Still a Worm World in the 2020s? An Overview of Risk Factors and Endemicity for Soil-Transmitted Helminthiasis. Acta Parasitol 2023; 68:481-495. [PMID: 37531011 DOI: 10.1007/s11686-023-00701-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 07/18/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Soil-transmitted helminthiasis (STH) is one of the most common chronic infections in developing countries associated with poor socioeconomic and sanitary conditions. The main objective of this overview was to evaluate the influence of environmental factors, risk factors related to the host, and control strategies on the prevalence of STH in different regions of the world. METHODS LILACS, PubMed, Web of Knowledge, Embase, the Cochrane Library, and Clinical Trials (gray literature) databases were used to obtain the systematic reviews published until December 2020. The methodological quality of systematic reviews was assessed using the standard criteria recommended by AMSTAR. RESULTS The initial results of the bibliographic search identified 1448 articles, of which 66 studies were read in full and 16 met the inclusion criteria. All the reviews included in this overview associated variations in the global prevalence of STH with at least one of the factors related to the environment, host, and/or control strategies. Climate, temperature, soil moisture, precipitation, mass drug administration, lack of access to water, sanitation and hygiene (WASH), and non-use of footwear were considered the main factors associated with the prevalence of STH. Socioeconomic factors, low educational level, and wearing shoes were universal factors related to prevalence, regardless of the location studied. CONCLUSION The combination of environmental factors, with factors associated with hosts that predispose infection and reinfection of helminths, as well as the adoption of control strategies based on the treatment of target populations instead of the entire population, influenced the prevalence of STH in all the continents evaluated.
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Affiliation(s)
- Adelson Ferreira Ramos Neto
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | | | - Luciana Maria de Oliveira
- Department of Morphology, Center of Biology and Health Sciences, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - Roseli La Corte
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - Sona Jain
- Postgraduate Program in Industrial Biotechnology, Tiradentes University, Aracaju, SE, 49010-390, Brazil
| | | | - Ricardo Toshio Fujiwara
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
- Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Silvio Santana Dolabella
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil.
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil.
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Phillips AE, Ower AK, Mekete K, Liyew EF, Maddren R, Belay H, Chernet M, Anjulo U, Mengistu B, Salasibew M, Tasew G, Anderson R. Association between water, sanitation, and hygiene access and the prevalence of soil-transmitted helminth and schistosome infections in Wolayita, Ethiopia. Parasit Vectors 2022; 15:410. [DOI: 10.1186/s13071-022-05465-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 09/03/2022] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
The Geshiyaro project is a 5-year intervention to assess the impact of community- and school-based water, sanitation, and hygiene (WaSH) interventions on reducing infection with soil-transmitted helminths (STH) and schistosome parasites in combination with deworming in Wolayita zone, Ethiopia.
Methods
A population-based, cross-sectional census and parasitological mapping activity was conducted between 2018 and 2019. Individuals in the census were identified using either a registered study ID card or biometric fingerprint to enable linkage of their household WaSH data with baseline STH and schistosome prevalence for risk analysis.
Results
Prevalence of STH was 15.5% for any STH species, 9.47% for Ascaris lumbricoides, 1.78% for Trichuris trichiura, and 7.24% for hookworm. Intestinal schistosomiasis (Schistosoma mansoni) infection prevalence was 0.85% by Kato Katz, 21.6% by POC-CCA trace positive (Tr +), and 13.3% trace negative (Tr-). Microhaematuria was 2.77%, with 0.13% of people examined with S. haematobium eggs detected by urine filtration. At the household level, increased (> 30 min) time taken to collect drinking water, sharing a latrine, and lack of handwashing facilities were all associated with a greater risk of A. lumbricoides, hookworm, and S. mansoni infection. Not disposing of infant stool at the household and clothes washing/recreational freshwater contact were significantly associated with higher risk of schistosomiasis infection. Aggregating WaSH data at the community level showed odds of A. lumbricoides, hookworm, and T. trichiura infection were significantly lower as both community sanitation coverage and access to improved drinking water improved.
Conclusions
The principal finding of this study is that lack of access to WaSH, such as improved drinking water and shared toilet and hand-washing facilities, were linked to an increased risk of infection with STH and schistosome parasites. These associations are difficult to establish at an individual household level because of wide variability in access between houses but are detectable when coverage is aggregated at the community level. Maintenance of WaSH facilities as well as increased access within the whole community is important in influencing the community-wide prevalence of infection with STH and schistosome parasites.
Graphical Abstract
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Johari NA, Annuzaili DA, El-Talabawy HF, Ba-Break M, Al-Mekhlafi AM, Al-Eryani S, Alkohlani AA, Gabrielli AF, Ben-Ismail R, Alhaidari S, Muaydh A, Alshami R, Al Gunaid M, Hamed A, Kamel N, Palacio K, Fleming F, French MD. National mapping of schistosomiasis, soil-transmitted helminthiasis and anaemia in Yemen: Towards better national control and elimination. PLoS Negl Trop Dis 2022; 16:e0010092. [PMID: 35333859 PMCID: PMC8986123 DOI: 10.1371/journal.pntd.0010092] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 04/06/2022] [Accepted: 02/17/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Schistosomiasis (SCH) and soil-transmitted helminthiasis (STH) are known to be endemic in Yemen. However, the distribution of both diseases had not previously been assessed by a well-structured national mapping study covering all governorates. The main aim of this study was, therefore, to map the prevalence of SCH and STH in Yemen in order to better inform implementation of effective national control and elimination interventions. The assessment of the distribution of anaemia was also included as a well-known consequence of infection with both SCH and STH. Secondarily, the study aimed to provide a broad indication of the impact of large-scale treatment on the distribution of infection. METHODOLOGY AND PRINCIPAL FINDINGS To achive these aims, 80,432 children (10-14 years old) from 2,664 schools in 332 of Yemen's 333 districts were included, in 2014, into this national cross-sectional survey. Countrywide, 63.3% (210/332) and 75.6% (251/332) of districts were found to be endemic for SCH and STH respectively. More districts were affected by intestinal than urogenital SCH (54.2% and 31.6% respectively). SCH infection was mostly mild and moderate, with no districts reporting high infection. One quarter (24.4%) of Yemeni districts had high or moderate levels of Ascaris lumbricoides infection. Infection with Trichuris trichiura was the second most common STH (44.9% of districts infected) after A. lumbricoides (68.1%). Hookworm was the least prevalent STH (9.0%). Anaemia was prevalent in 96.4% of districts; it represented a severe public health problem (prevalence ≥ 40%) in 26.5% of districts, and a mild to moderate problem in two thirds of the districts (33.7% and 36.1% respectively). CONCLUSION This study provided the first comprehensive mapping of SCH, STH, and anaemia across the country. This formed the basis for evaluating and continuing the national control and elimination programme for these neglected tropical diseases in Yemen.
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Affiliation(s)
- Nur Alia Johari
- Schistosomiasis Control Initiative Foundation, London, United Kingdom
| | | | - Hani Farouk El-Talabawy
- Regional Office for the Eastern Mediterranean, Department of Information, Evidence and Research, Department of Communicable Diseases, World Health Organization, Cairo, Egypt
| | - Maryam Ba-Break
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, United Kingdom
| | - Abdulsalam M. Al-Mekhlafi
- Department of Parasitology, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen
| | - Samira Al-Eryani
- Department of Parasitology, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen
| | | | - Albis Francesco Gabrielli
- Regional Office for the Eastern Mediterranean, Department of Communicable Diseases, World Health Organization, Cairo, Egypt
| | - Riadh Ben-Ismail
- Regional Office for the Eastern Mediterranean, Department of Communicable Diseases, World Health Organization, Cairo, Egypt
| | - Sami Alhaidari
- The National Schistosomiasis Control Programme (NSCP), Department of Primary Health Care, Ministry of Public Health and Population, Sana’a, Yemen
| | - Adel Muaydh
- The National Schistosomiasis Control Programme (NSCP), Department of Primary Health Care, Ministry of Public Health and Population, Sana’a, Yemen
| | - Rasheed Alshami
- The National Schistosomiasis Control Programme (NSCP), Department of Primary Health Care, Ministry of Public Health and Population, Sana’a, Yemen
| | - Magid Al Gunaid
- The National Schistosomiasis Control Programme (NSCP), Department of Primary Health Care, Ministry of Public Health and Population, Sana’a, Yemen
| | - Alaa Hamed
- The World Bank, Washington D.C, United States of America
| | - Nehad Kamel
- The World Bank, Washington D.C, United States of America
| | - Karen Palacio
- The End Fund, New York, New York, United States of America
| | - Fiona Fleming
- Schistosomiasis Control Initiative Foundation, London, United Kingdom
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Prevalence of Schistosoma mansoni and Associated Risk Factors in Human and Biomphalaria Snails in Ethiopia: A Systematic Review and Meta-analysis. Acta Parasitol 2022; 67:31-48. [PMID: 34259986 DOI: 10.1007/s11686-021-00449-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/28/2021] [Indexed: 01/27/2023]
Abstract
PURPOSE Schistosomiasis is one of the leading chronic parasitic diseases in Ethiopia. We aimed to summarize the prevalence of S. mansoni in human and Biomphalaria snails as well as risk factors in Ethiopia. METHODS Literature search was carried out from Scopus, Google Scholar, Science Direct and PubMed which reported Schistosoma mansoni infection in human and Biomphalaria snails in Ethiopia. The overall prevalence was estimated by a random-effect model and heterogeneities among studies were assessed by I2 test. RESULTS A total of 178,251 participants and 1,097 snails were tested for the presence of S. mansoni in the eligible studies. The pooled prevalence of S. mansoni was 32.5% (95% CI 28.0-37.0) and 15.9% (95% CI - 5.6-37.5) in human and Biomphalaria snails in Ethiopia, respectively. The highest pooled prevalence was 43.2% (95% CI 27.3-59.1) in South Nations and National Peoples region while the lowest pooled prevalence was 25% (95% CI 19.3-30.7) observed in the Afar region. Interestingly, the pooled prevalence of S. mansoni declined from 40.7% (95% CI 33-48.4) to 22.4% (95% CI 18.5-26.3) after the launching of mass drug administration (MDA). The analysis of risk factors showed that swimming habit (OR, 2.78; 95% CI 2.35-3.21) and participation in irrigation (OR, 2.69; 95% CI 1.45-3.73) were independent predictors for S. mansoni infection. CONCLUSION This study revealed that about one-third of human and nearly 16% of Biomphalaria snails were infected with S. mansoni in Ethiopia. This review indicated that the prevalence of S. mansoni declined after the implementation of MDA. This study highlights the importance of further integrated approaches for better control of schistosomiasis in Ethiopia.
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Scavuzzo CM, Scavuzzo JM, Campero MN, Anegagrie M, Aramendia AA, Benito A, Periago V. Feature importance: Opening a soil-transmitted helminth machine learning model via SHAP. Infect Dis Model 2022; 7:262-276. [PMID: 35224316 PMCID: PMC8844643 DOI: 10.1016/j.idm.2022.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 01/19/2022] [Accepted: 01/29/2022] [Indexed: 01/20/2023] Open
Abstract
In the field of landscape epidemiology, the contribution of machine learning (ML) to modeling of epidemiological risk scenarios presents itself as a good alternative. This study aims to break with the ”black box” paradigm that underlies the application of automatic learning techniques by using SHAP to determine the contribution of each variable in ML models applied to geospatial health, using the prevalence of hookworms, intestinal parasites, in Ethiopia, where they are widely distributed; the country bears the third-highest burden of hookworm in Sub-Saharan Africa. XGBoost software was used, a very popular ML model, to fit and analyze the data. The Python SHAP library was used to understand the importance in the trained model, of the variables for predictions. The description of the contribution of these variables on a particular prediction was obtained, using different types of plot methods. The results show that the ML models are superior to the classical statistical models; not only demonstrating similar results but also explaining, by using the SHAP package, the influence and interactions between the variables in the generated models. This analysis provides information to help understand the epidemiological problem presented and provides a tool for similar studies.
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Genet A, Motbainor A, Samuel T, Azage M. Prevalence and associated factors of soil transmitted helminthiasis among school-age children in wetland and non-wetland areas of Blue Nile Basins, northwest Ethiopia: A community-based comparative study. SAGE Open Med 2021; 9:20503121211063354. [PMID: 34917385 PMCID: PMC8669120 DOI: 10.1177/20503121211063354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/01/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Different interventions have been done to reduce the burden of soil-transmitted helminths (STH). The available evidences in Ethiopia in either school or community-based school-aged children (SAC) have limitation in wetland areas. This study assessed the prevalence and associated factors of STH infection among SAC in wetland and non-wetland areas of Blue Nile Basins, Amhara Region, Northwest Ethiopia. METHOD A community-based comparative study was conducted from October to November, 2019. Multistage stratified random sampling technique used to select 716 SAC. Data were collected using structured questionnaire and observational checklist. Stool samples were collected from children using tight-fitting plastic cups following the standard procedures. Data were coded and entered into Epi data version 4.6 and exported to SPSS version 20 software. Bivariate and multivariable logistic regression analysis was employed to identify factors associated with STH. RESULTS The overall prevalence of STH was 30.30% (95% CI: 26.90, 33.90) and did not show significant variation between wetland (33.60% (95% CI: 28.80, 39.60%)) and non-wetland (27.0% (95% CI: (21.90, 31.60)) areas. Presence of human feces near the house and certain habits such as nail trimming and playing with mud/soil was not different between wetland and non-wetlands. Nonetheless, the presence of human feces near the house of respondents was found to be significantly associated with STH infection (p value < 0.001). Moreover, other factors significantly associated with STH infection were lack of nail trimming (p value < 0.001) and playing with mud/soil (p value < 0.01). CONCLUSIONS The prevalence of STH was high and did not show significant variation between the two areas. Emphasis needs to be given for hygiene and lifestyle-related factors.
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Affiliation(s)
- Almaw Genet
- Dangila Woreda Health Office, Dangila, Ethiopia
| | - Achenef Motbainor
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tsion Samuel
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Muluken Azage
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Hazell L, Allan F, Emery AM, Templeton MR. Ultraviolet disinfection of Schistosoma mansoni cercariae in water. PLoS Negl Trop Dis 2021; 15:e0009572. [PMID: 34228750 PMCID: PMC8284627 DOI: 10.1371/journal.pntd.0009572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/16/2021] [Accepted: 06/17/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Schistosomiasis is a parasitic disease that is transmitted by skin contact with waterborne schistosome cercariae. Mass drug administration with praziquantel is an effective control method, but it cannot prevent reinfection if contact with cercariae infested water continues. Providing safe water for contact activities such as laundry and bathing can help to reduce transmission. In this study we examine the direct effect of UV light on Schistosoma mansoni cercariae using ultraviolet light-emitting diodes (UV LEDs) and a low-pressure (LP) mercury arc discharge lamp. METHODOLOGY S. mansoni cercariae were exposed to UV light at four peak wavelengths: 255 nm, 265 nm, 285 nm (UV LEDs), and 253.7 nm (LP lamp) using bench scale collimated beam apparatus. The UV fluence ranged from 0-300 mJ/cm2 at each wavelength. Cercariae were studied under a stereo-microscope at 0, 60, and 180 minutes post-exposure and the viability of cercariae was determined by assessing their motility and morphology. CONCLUSION Very high UV fluences were required to kill S. mansoni cercariae, when compared to most other waterborne pathogens. At 265 nm a fluence of 247 mJ/cm2 (95% confidence interval (CI): 234-261 mJ/cm2) was required to achieve a 1-log10 reduction at 0 minutes post-exposure. Cercariae were visibly damaged at lower fluences, and the log reduction increased with time post-exposure at all wavelengths. Fluences of 127 mJ/cm2 (95% CI: 111-146 mJ/cm2) and 99 mJ/cm2 (95% CI: 85-113 mJ/cm2) were required to achieve a 1-log10 reduction at 60 and 180 minutes post-exposure at 265 nm. At 0 minutes post-exposure 285 nm was slightly less effective, but there was no statistical difference between 265 nm and 285 nm after 60 minutes. The least effective wavelengths were 255 nm and 253.7 nm. Due to the high fluences required, UV disinfection is unlikely to be an energy- or cost-efficient water treatment method against schistosome cercariae when compared to other methods such as chlorination, unless it can be demonstrated that UV-damaged cercariae are non-infective using alternative assay methods or there are improvements in UV LED technology.
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Affiliation(s)
- Lucinda Hazell
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
- * E-mail:
| | - Fiona Allan
- Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Aidan M. Emery
- Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Michael R. Templeton
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
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Anegagrie M, Lanfri S, Aramendia AA, Scavuzzo CM, Herrador Z, Benito A, Periago MV. Environmental characteristics around the household and their association with hookworm infection in rural communities from Bahir Dar, Amhara Region, Ethiopia. PLoS Negl Trop Dis 2021; 15:e0009466. [PMID: 34157019 PMCID: PMC8219153 DOI: 10.1371/journal.pntd.0009466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/11/2021] [Indexed: 01/09/2023] Open
Abstract
Soil-Transmitted Helminths (STH) are highly prevalent Neglected Tropical Disease in Ethiopia, an estimated 26 million are infected. Geographic Information Systems and Remote Sensing (RS) technologies assist data mapping and analysis, and the prediction of the spatial distribution of infection in relation to environmental variables. The influence of socioeconomic, environmental and soil characteristics on hookworm infection at the individual and household level is explored in order to identify spatial patterns of infection in rural villages from Zenzelema (Amhara region). Inhabitants greater than 5 years old were recruited in order to assess the presence of STH. Socioeconomic and hookworm infection variables at the household level and environmental variables and soil characteristics using RS were obtained. The dominant STH found was hookworm. Individuals which practiced open defecation and those without electricity had a significant higher number of hookworm eggs in their stool. Additionally, adults showed statistically higher hookworm egg counts than children. Nonetheless, the probability of hookworm infection was not determined by socioeconomic conditions but by environmental characteristics surrounding the households, including a combination of vigorous vegetation and bare soil, high temperatures, and compacted soils (high bulk density) with more acidic pH, given a pH of 6.0 is optimal for hatching of hookworm eggs. The identification of high-risk environmental areas provides a useful tool for planning, targeting and monitoring of control measures, including not only children but also adults when hookworm is concerned.
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Affiliation(s)
- Melaku Anegagrie
- Fundación Mundo Sano, Madrid, Spain
- National Centre for Tropical Medicine, Institute of Health Carlos III, Madrid, Spain
| | - Sofía Lanfri
- Instituto de Altos Estudios Espaciales Mario Gulich, Comisión Nacional de Actividades Espaciales, Universidad Nacional de Córdoba, Córdoba, Argentina
- Fundación Mundo Sano, Buenos Aires, Argentina
| | - Aranzazu Amor Aramendia
- Fundación Mundo Sano, Madrid, Spain
- National Centre for Tropical Medicine, Institute of Health Carlos III, Madrid, Spain
| | - Carlos Matías Scavuzzo
- Instituto de Altos Estudios Espaciales Mario Gulich, Comisión Nacional de Actividades Espaciales, Universidad Nacional de Córdoba, Córdoba, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Zaida Herrador
- National Centre for Tropical Medicine, Institute of Health Carlos III, Madrid, Spain
| | - Agustín Benito
- National Centre for Tropical Medicine, Institute of Health Carlos III, Madrid, Spain
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Ledger ML, Micarelli I, Ward D, Prowse TL, Carroll M, Killgrove K, Rice C, Franconi T, Tafuri MA, Manzi G, Mitchell PD. Gastrointestinal infection in Italy during the Roman Imperial and Longobard periods: A paleoparasitological analysis of sediment from skeletal remains and sewer drains. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2021; 33:61-71. [PMID: 33744834 DOI: 10.1016/j.ijpp.2021.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/16/2021] [Accepted: 03/10/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This study aims to investigate parasitic infection in Italy during the Roman period (27 BCE-476 CE) and subsequent Longobard (Lombard) period (6th-8th CE). MATERIALS Sediment samples from drains and burials from Roman Imperial-period sites in Italy (Lucus Feroniae, Oplontis, Vacone, and Vagnari), Late Antique and Longobard-period burials at Selvicciola (ca. 4th-8th CE), and Longobard-period burials at Vacone and Povegliano Veronese. METHODS Microscopy was used to identify helminth eggs and enzyme-linked immunosorbent assay (ELISA) to detect protozoan antigens. RESULTS Roundworm and whipworm were found in pelvic sediment from Roman-period burials, while roundworm and the protozoan Giardia duodenalis were identified in Roman-period drains. In pelvic sediment from the Late Antique through Longobard periods, roundworm and Taenia tapeworm eggs were identified. CONCLUSIONS Fecal-oral parasites were found throughout Imperial Roman Italy, suggesting that gastrointestinal infections caused a significant disease burden. In the Longobard period we see continuity in transmission of fecal-oral parasites, and the appearance of zoonotic parasites acquired from eating undercooked meat. SIGNIFICANCE A wealth of information exists about certain diseases in the Roman period, but relatively little is known about intestinal parasites in Italy during the Roman and Longobard periods. This is the first evidence for Giardia in Roman period Italy, and for any parasites in the Longobard period in Italy. LIMITATIONS Low egg concentrations and lack of controls for some samples makes it difficult to differentiate true infections from environmental contamination in some cases. SUGGESTIONS FOR FUTURE RESEARCH Continual study of samples from Roman and Longobard period Italy.
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Affiliation(s)
- Marissa L Ledger
- Department of Archaeology, University of Cambridge, The Henry Wellcome Building, Fitzwilliam Street, Cambridge, CB2 1QH, UK.
| | - Ileana Micarelli
- Department of Environmental Biology, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Roma, Italy
| | - Devin Ward
- Department of Anthropology, University of Toronto, ON, Canada
| | - Tracy L Prowse
- Department of Anthropology, McMaster University, Hamilton, ON, Canada
| | | | - Kristina Killgrove
- Department of Anthropology, University of North Carolina at Chapel Hill, USA
| | - Candace Rice
- Joukowsky Institute for Archaeology and the Ancient World, Brown University, USA
| | - Tyler Franconi
- Joukowsky Institute for Archaeology and the Ancient World, Brown University, USA
| | - Mary Anne Tafuri
- Department of Environmental Biology, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Roma, Italy
| | - Giorgio Manzi
- Department of Environmental Biology, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Roma, Italy
| | - Piers D Mitchell
- Department of Archaeology, University of Cambridge, The Henry Wellcome Building, Fitzwilliam Street, Cambridge, CB2 1QH, UK
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Helminth infections among rural schoolchildren in Southern Ethiopia: A cross-sectional multilevel and zero-inflated regression model. PLoS Negl Trop Dis 2020; 14:e0008002. [PMID: 33351816 PMCID: PMC7755205 DOI: 10.1371/journal.pntd.0008002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 10/20/2020] [Indexed: 11/19/2022] Open
Abstract
Although the prevalence of helminths infection among schoolchildren is known, there has been little progress in the application of count model for modelling the risk factors of helminths egg. Only a few studies applied multilevel analysis to explore the variation in helminths prevalence across schools and classes. This study aimed to assess the prevalence, intensity of helminths infection, and identify risk factors at the individual-, household-, and school-level among schoolchildren in Southern Ethiopia. Using multistage random sampling, we recruited 864 students in the Wonago District. We applied multilevel-logistic and zero-inflated negative binomial regression models (ZINB). Risk factors were concentrated at the individual level; school-level and class-level variables explained less than 5% of the variance. The overall helminths prevalence was 56% (479/850); Trichuris trichiura prevalence was 42.4% (360/850); and Ascaris lumbricoides prevalence was 18.7% (159/850). The rate of any helminths increased among thin children (AOR: 1.73 [95% CI: (1.04, 2.90]), anemic (AOR: 1.45 [95% CI: 1.04, 2.03]), mothers who had no formal education (AOR: 2.08 [95% CI: 1.25, 3.47]), and those in households using open containers for water storage (AOR: 2.06 [95% CI: 1.07, 3.99]). In the ZINB model, A. lumbricoides infection intensity increased with increasing age (AOR: 1.08 [95% CI: 1.01, 1.16]) and unclean fingernails (AOR: 1.47 [95% CI: 1.07, 2.03]). Handwashing with soap (AOR: 0.68 [95% CI: 0.48, 0.95]), de-worming treatment [AOR: 0.57 (95% CI: 0.33, 0.98)], and using water from protected sources [AOR: 0.46 (95% CI: 0.28, 0.77)] were found to be protective against helminths infection. After controlling for clustering effects at the school and class levels and accounting for excess zeros in fecal egg counts, we found an association between helminths infection and the following variables: age, thinness, anemia, unclean fingernails, handwashing, de-worming treatment, mother's education, household water source, and water storage protection. Improving hygiene behavior, providing safe water at school and home, and strengthening de-worming programs is required to improve the health of schoolchildren in rural Gedeo.
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Ntajal J, Evers M, Kistemann T, Falkenberg T. Influence of human-surface water interactions on the transmission of urinary schistosomiasis in the Lower Densu River basin, Ghana. Soc Sci Med 2020; 288:113546. [PMID: 33277069 DOI: 10.1016/j.socscimed.2020.113546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/17/2020] [Accepted: 11/19/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Joshua Ntajal
- Department of Geography, University of Bonn, Germany; Center for Development Research, University of Bonn, Germany.
| | - Mariele Evers
- Department of Geography, University of Bonn, Germany
| | - Thomas Kistemann
- GeoHealth Centre, Institute for Hygiene and Public Health, University of Bonn, Germany
| | - Timo Falkenberg
- Center for Development Research, University of Bonn, Germany; GeoHealth Centre, Institute for Hygiene and Public Health, University of Bonn, Germany
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Mekonnen Z, Hassen D, Debalke S, Tiruneh A, Asres Y, Chelkeba L, Zemene E, Belachew T. Soil-transmitted helminth infections and nutritional status of school children in government elementary schools in Jimma Town, Southwestern Ethiopia. SAGE Open Med 2020; 8:2050312120954696. [PMID: 32953118 PMCID: PMC7475784 DOI: 10.1177/2050312120954696] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 08/11/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Soil-transmitted helminth infections and malnutrition are major health problems of school-age children in developing countries. Malnutrition and soil-transmitted helminth infections often co-exist with synergetic consequences. Objective The aim of this study was to determine the prevalence and intensity of soil-transmitted helminths and its association with nutritional status of school-age children. Methods School-based cross-sectional study was carried out from April to May 2014 among 404 elementary school-age children in Jimma Town, Southwest Ethiopia. Data on background characteristics were collected using structured interviewer administered questionnaire. Anthropometric measurements were taken according to World Health Organization standard. Fresh single stool sample was collected from each study participant and examined using direct wet mount and McMaster techniques. Anthropometric indices were generated using WHO AnthroPlus software. Multivariable logistic regression models were fitted to isolate independent predictors of intestinal parasitic infection and nutritional status using STATA-MP software. All tests were two-sided and P < 0.05 was used to declare statistical significance. Results The overall prevalence of intestinal parasites and soil-transmitted helminths were 68.6% (n = 277) and 55.0% (n = 222), respectively. A total of eight species of intestinal parasites were identified in this study, Trichuris trichiura being the most common parasite identified followed by Ascaris lumbricoides. Study participants who had a habit of open defecation were two times more likely to be infected with soil-transmitted helminths (adjusted odds ratio = 1.9, 95% confidence interval: 1.0-3.4). The overall prevalence of stunting and thinness were 21.0% (n = 85) and 6.9% (n = 28), respectively. The odds of stunting was significantly high (adjusted odds ratio = 4.0, 95% confidence interval: 1.7-9.7) among children who had fathers working as daily labourers and children with personal dietary diversity score of ⩽3 (adjusted odds ratio = 3.5, 95% confidence interval: 1.5-8.0). T. trichiura infection (adjusted odds ratio = 9.4, 95% confidence interval: 2.0-44.8) was identified as an independent predictor of stunting among school-age children. Conclusion Both the prevalence of soil-transmitted helminths and stunting are high among school-age children in Jimma Town. Although there was no statistically significant association between the STHs, in general, T. trichiura was reported as predictor of stunting. The results imply the need for strengthening strategies for reduction of parasitic infection to curb the pervasively high prevalence of stunting.
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Affiliation(s)
- Zeleke Mekonnen
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | | | - Serkadis Debalke
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Abebaw Tiruneh
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Yaregal Asres
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Legesse Chelkeba
- Department of Clinical Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Endalew Zemene
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia
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Leta GT, Mekete K, Wuletaw Y, Gebretsadik A, Sime H, Mekasha S, Woyessa A, Shafi O, Vercruysse J, Grimes JET, Gardiner I, French M, Levecke B, Drake L, Harrison W, Fenwick A. National mapping of soil-transmitted helminth and schistosome infections in Ethiopia. Parasit Vectors 2020; 13:437. [PMID: 32873333 PMCID: PMC7466696 DOI: 10.1186/s13071-020-04317-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 08/25/2020] [Indexed: 11/10/2022] Open
Abstract
Background An accurate understanding of the geographical distributions of both soil-transmitted helminths (STHs; Ascaris lumbricoides, Trichuris trichiura, and the hookworms Necator americanus and Ancylostoma duodenale) and schistosomes (SCH; Schistosoma mansoni and S. haematobium) is pivotal to be able to effectively design and implement mass drug administration (MDA) programmes. The objective of this study was to provide up-to-date data on the distribution of both STH and SCH in Ethiopia to inform the design of the national control program and to be able to efficiently achieve the 75% MDA coverage target set by the WHO. Methods Between 2013 and 2015, we assessed the distributions of STH and SCH infections in a nationwide survey covering 153,238 school-aged children (aged 5–15 years), from 625 woredas (districts), representing all nine Regional States and two City Administrations of Ethiopia. Nationwide disease maps were developed at the woreda level to enable recommendations on the design of the national MDA programme. Results The prevalence of any STH infection across the study population was 21.7%, with A. lumbricoides (12.8%) being the most prevalent STH, followed by hookworms (7.6%) and T. trichiura (5.9%). The prevalence for any SCH was 4.0% in areas where both SCH species were evaluated. Schistosoma mansoni was the most prevalent SCH (3.5 vs 0.3%). STHs were more prevalent in southwest Ethiopia, whereas SCH was found mostly in the west and northeast of the country. The prevalence of moderate-to-heavy intensity infections was 2.0% for STHs and 1.6% for SCH. For STH, a total of 251 woredas were classified as moderately (n = 178) or highly endemic (n = 73), and therefore qualify for an annual and biannual MDA program, respectively. For SCH, 67 woredas were classified as endemic and 8 as highly endemic, and hence they require every two years and annual MDA programme, respectively. Conclusions The results confirm that Ethiopia is endemic for both STHs and SCH, posing a significant public health problem. Following the WHO recommendations on mass drug administration, 18 and 14 million school-aged children are in need of MDA for STHs and SCH, respectively, based on the number of SACs that live on the eligible geographical areas.![]()
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Affiliation(s)
- Gemechu Tadesse Leta
- Ethiopian Public Health Institute, PO Box 1242/5654, Addis Ababa, Ethiopia. .,Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Kalkidan Mekete
- Ethiopian Public Health Institute, PO Box 1242/5654, Addis Ababa, Ethiopia
| | - Yonas Wuletaw
- Ethiopian Public Health Institute, PO Box 1242/5654, Addis Ababa, Ethiopia
| | - Abeba Gebretsadik
- Ethiopian Public Health Institute, PO Box 1242/5654, Addis Ababa, Ethiopia
| | - Heven Sime
- Ethiopian Public Health Institute, PO Box 1242/5654, Addis Ababa, Ethiopia
| | - Sindew Mekasha
- Ethiopian Public Health Institute, PO Box 1242/5654, Addis Ababa, Ethiopia
| | - Adugna Woyessa
- Ethiopian Public Health Institute, PO Box 1242/5654, Addis Ababa, Ethiopia
| | - Oumer Shafi
- Federal Ministry of Health, PO Box 1234, Addis Ababa, Ethiopia
| | - Jozef Vercruysse
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Jack E T Grimes
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London, SW7 2AZ, UK
| | - Iain Gardiner
- Partnership for Child Development, Department of Infectious Disease Epidemiology, St Mary's Campus, Imperial College London, London, W2 1PG, UK
| | - Michael French
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, St Mary's Campus, Imperial College London, London, W2 1PG, UK.,RTI International, Washington D.C, USA
| | - Bruno Levecke
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Lesley Drake
- Partnership for Child Development, Department of Infectious Disease Epidemiology, St Mary's Campus, Imperial College London, London, W2 1PG, UK
| | - Wendy Harrison
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, St Mary's Campus, Imperial College London, London, W2 1PG, UK
| | - Alan Fenwick
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, St Mary's Campus, Imperial College London, London, W2 1PG, UK
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Braun L, Sylivester YD, Zerefa MD, Maru M, Allan F, Zewge F, Emery AM, Kinung’hi S, Templeton MR. Chlorination of Schistosoma mansoni cercariae. PLoS Negl Trop Dis 2020; 14:e0008665. [PMID: 32822356 PMCID: PMC7467251 DOI: 10.1371/journal.pntd.0008665] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/02/2020] [Accepted: 08/01/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Schistosomiasis is a water-based disease acquired through contact with cercaria-infested water. Communities living in endemic regions often rely on parasite-contaminated freshwater bodies for their daily water contact activities, resulting in recurring schistosomiasis infection. In such instances, water treatment can provide safe water on a household or community scale. However, to-date there are no water treatment guidelines that provide information on how to treat water containing schistosome cercariae. Here, we rigorously test the effectiveness of chlorine against Schistosoma mansoni cercariae. METHOD S. mansoni cercariae were chlorinated using sodium hypochlorite under lab and field condition. The water pH was controlled at 6.5, 7.0 or 7.5, the water temperature at 20°C or 27°C, and the chlorine dose at 1, 2 or 3 mg/l. Experiments were conducted up to contact times of 45 minutes. 100 cercariae were used per experiment, thereby achieving up to 2-log10 inactivations of cercariae. Experiments were replicated under field conditions at Lake Victoria, Tanzania. CONCLUSION A CT (residual chlorine concentration x chlorine contact time) value of 26±4 mg·min/l is required to achieve a 2-log10 inactivation of S. mansoni cercariae under the most conservative condition tested (pH 7.5, 20°C). Field and lab-cultivated cercariae show similar chlorine sensitivities. A CT value of 30 mg·min/l is therefore recommended to disinfect cercaria-infested water, though safety factors may be required, depending on water quality and operating conditions. This CT value can be achieved with a chlorine residual of 1 mg/l after a contact time of 30 minutes, for example. This recommendation can be used to provide safe water for household and recreational water activities in communities that lack safe alternative water sources.
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Affiliation(s)
- Laura Braun
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London SW7 2AZ, United Kingdom
| | | | - Meseret Dessalegne Zerefa
- College of Natural and Computational Sciences, Addis Ababa University, Arat Kilo, Addis Ababa, Ethiopia
| | - Muluwork Maru
- College of Natural and Computational Sciences, Addis Ababa University, Arat Kilo, Addis Ababa, Ethiopia
| | - Fiona Allan
- Wolfson Wellcome Biomedical Laboratories, Departssment of Life Sciences, Natural History Museum, Cromwell Road, London SW7 5BD, United Kingdom
| | - Feleke Zewge
- College of Natural and Computational Sciences, Addis Ababa University, Arat Kilo, Addis Ababa, Ethiopia
| | - Aidan M. Emery
- Wolfson Wellcome Biomedical Laboratories, Departssment of Life Sciences, Natural History Museum, Cromwell Road, London SW7 5BD, United Kingdom
| | - Safari Kinung’hi
- National Institute for Medical Research, Mwanza Center, Isamilo Street, Ilemela, Mwanza, Tanzania
| | - Michael R. Templeton
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London SW7 2AZ, United Kingdom
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Prevalence of Intestinal Parasitic Infections and Associated Water, Sanitation, and Hygiene Risk Factors among School Children in Mwea Irrigation Scheme, Kirinyaga County, Kenya. J Trop Med 2020; 2020:3974156. [PMID: 32454837 PMCID: PMC7238387 DOI: 10.1155/2020/3974156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 03/20/2020] [Accepted: 04/07/2020] [Indexed: 12/23/2022] Open
Abstract
School children bear a significant burden of intestinal parasitic infections. Because they spend most of their time at home and school, it is necessary to identify the key water, sanitation, and hygiene (WASH) factors associated with these infections in both environments. This was a cross-sectional survey conducted in Mwea West, Kirinyaga County. 180 primary school children aged 8–14 years were randomly selected from three schools (Mianya, Mbui Njeru, and Mukou primary schools). Questionnaires and checklists were administered and single stool samples were collected. Stool samples were microscopically examined for Schistosoma mansoni, soil-transmitted helminths, and protozoan infections. Data on WASH were obtained at home and school. The factors significantly associated with S. mansoni and intestinal protozoa infections in the school children were determined using univariable and multivariable logistic regression models reporting the odds ratio at 95% confidence intervals. The overall prevalence of S. mansoni and intestinal protozoa infections was 70.5% (95% CI: 59.1–84.3) and 32.7% (95% CI: 26.8–40.1), respectively. Only one case of STH (A. lumbricoides) was identified. The prevalence of coinfections of S. mansoni and intestinal protozoa infections was 22.8% (95% CI: 19.2–27.1). An increased prevalence of S. mansoni infection was associated with children above 12 years (aOR = 3.19, p=0.015), those in Mianya primary (aOR = 1.23, p=0.001), those in Mukou primary (aOR = 3.19, p=0.001), and reported behavior of wearing shoes at home (aOR = 1.67, p=0.010). However, handwashing behavior after defecation at home (aOR = 0.39, p=0.001) was protective against S. mansoni infection. For any protozoan infection, male children had increased odds of infection (aOR = 2.41, p=0.001) while use of wiping material (aOR = 0.55, p=0.019) and water contact (aOR = 0.32, p=0.001) was protective against intestinal protozoa infections. Infections with S. mansoni and any protozoa and their coinfection were present. Findings revealed that several hygiene factors were protective against infections while other were risk factors. Therefore, deworming should be complemented with behavior education on hygienic habits.
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Braun L, Hazell L, Webb AJ, Allan F, Emery AM, Templeton MR. Determining the viability of Schistosoma mansoni cercariae using fluorescence assays: An application for water treatment. PLoS Negl Trop Dis 2020; 14:e0008176. [PMID: 32214320 PMCID: PMC7138324 DOI: 10.1371/journal.pntd.0008176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 04/07/2020] [Accepted: 02/27/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Schistosome cercariae are the human-infectious stage of the Schistosoma parasite. They are shed by snail intermediate hosts living in freshwater, and penetrate the skin of the human host to develop into schistosomes, resulting in schistosomiasis infection. Water treatment (e.g. filtration or chlorination) is one way of cutting disease transmission; it kills or removes cercariae to provide safe water for people to use for activities such as bathing or laundry as an alternative to infested lakes or rivers. At present, there is no standard method for assessing the effectiveness of water treatment processes on cercariae. Examining cercarial movement under a microscope is the most common method, yet it is subjective and time-consuming. Hence, there is a need to develop and verify accurate, high-throughput assays for quantifying cercarial viability. METHOD We tested two fluorescence assays for their ability to accurately determine cercarial viability in water samples, using S. mansoni cercariae released from infected snails in the Schistosomiasis Collection at the Natural History Museum, London. These assays consist of dual stains, namely a vital and non-vital dye; fluorescein diacetate (FDA) and Hoechst, and FDA and Propidium Iodide. We also compared the results of the fluorescence assays to the viability determined by microscopy. CONCLUSION Both fluorescence assays can detect the viability of cercariae to an accuracy of at least 92.2% ± 6.3%. Comparing the assays to microscopy, no statistically significant difference was found between the method's viability results. However, the fluorescence assays are less subjective and less time-consuming than microscopy, and therefore present a promising method for quantifying the viability of schistosome cercariae in water samples.
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Affiliation(s)
- Laura Braun
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Lucinda Hazell
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Alexander J Webb
- Section of Structural and Synthetic Biology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Fiona Allan
- Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Aidan M Emery
- Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Michael R Templeton
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
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Influences of Land-Use Dynamics and Surface Water Systems Interactions on Water-Related Infectious Diseases—A Systematic Review. WATER 2020. [DOI: 10.3390/w12030631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Human interactions with surface water systems, through land-use dynamics, can influence the transmission of infectious water-related diseases. As a result, the aim of our study was to explore and examine the state of scientific evidence on the influences of these interactions on water-related infectious disease outcomes from a global perspective. A systematic review was conducted, using 54 peer-reviewed research articles published between 1995 and August 2019. The study revealed that there has been an increase in the number of publications since 2009; however, few of these publications (n = 6) made explicit linkages to the topic. It was found that urban and agricultural land-use changes had relatively high adverse impacts on water quality, due to high concentrations of fecal matter, heavy metals, and nutrients in surface water systems. Water systems were found as the common “vehicle” for infectious disease transmission, which in turn had linkages to sanitation and hygiene conditions. The study found explicit linkages between human–surface water interaction patterns and the transmission of water-based disease. However, weak and complex linkages were found between land-use change and the transmission of water-borne disease, due to multiple pathways and the dynamics of the other determinants of the disease. Therefore, further research studies, using interdisciplinary and transdisciplinary approaches to investigate and enhance a deeper understanding of these complexities and linkages among land use, surface water quality, and water-related infectious diseases, is crucial in developing integrated measures for sustainable water quality monitoring and diseases prevention.
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Watson J, Cumming O, Aunger R, Deola C, Chase RP, Dreibelbis R. Child handwashing in an internally displaced persons camp in Northern Iraq: A qualitative multi-method exploration of motivational drivers and other handwashing determinants. PLoS One 2020; 15:e0228482. [PMID: 32012206 PMCID: PMC6996827 DOI: 10.1371/journal.pone.0228482] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 01/16/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Children in humanitarian situations are particularly vulnerable to diseases such as diarrhoea. Handwashing with soap can greatly reduce transmission but handwashing rates are often low and traditional interventions ineffective. To aid future intervention design, this study aims to understand the determinants of child handwashing and the key motivational drivers of children's behaviour within a specific humanitarian setting. METHODS In an internally displaced persons camp in Northern Iraq we conducted a series of 36 friendship-paired interviews with children aged 7-12 years, six semi-structured caregiver interviews, and three semi-structured hygiene promoter interviews. Perceived determinants of child handwashing were explored qualitatively, and motivational drivers were explored quantitatively with children in a rating exercise. Qualitative data were analysed thematically, using an inductive approach, and logistic regression analyses of motive rating data were performed to determine the predicted probabilities of motives being rated as important. RESULTS Access to soap and water was perceived to be high across all participant groups. Children, caregivers and hygiene promoters all perceive the determinants of child handwashing to be associated with familial role, environmental factors pertaining to location and quality of handwashing materials and facilities, and level of exposure to hygiene promotion, and children also attribute their handwashing to social norms. We find that children in this context are motived most by play and nurture. CONCLUSIONS Provision of soap and water alone is not sufficient to encourage children to practice handwashing with soap in a humanitarian context. Our findings suggest that equal consideration should be given to the quality and location of handwashing materials and facilities and social norms could be leveraged to promote and enhance child handwashing. Motive-based interventions targeting play or nurture may be a promising approach and are likely most effective when used in conjunction, along with other motivational drivers such as affiliation and love.
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Affiliation(s)
- Julie Watson
- Department for Disease Control, London School of Hygiene and Tropical Medicine, London, England, United Kingdom
- * E-mail:
| | - Oliver Cumming
- Department for Disease Control, London School of Hygiene and Tropical Medicine, London, England, United Kingdom
| | - Robert Aunger
- Department for Disease Control, London School of Hygiene and Tropical Medicine, London, England, United Kingdom
| | - Claudio Deola
- Humanitarian Department, Save the Children, London, England, United Kingdom
| | - Rachel P. Chase
- Independent researcher, Columbus, Ohio, United States of America
| | - Robert Dreibelbis
- Department for Disease Control, London School of Hygiene and Tropical Medicine, London, England, United Kingdom
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Disparities in the prevalence and risk factors of anaemia among children aged 6–24 months and 25–59 months in Ethiopia. J Nutr Sci 2020; 9:e36. [PMID: 32983421 PMCID: PMC7503181 DOI: 10.1017/jns.2020.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/18/2020] [Accepted: 07/22/2020] [Indexed: 12/25/2022] Open
Abstract
Despite global efforts made to address anaemia, the prevalence remains high in most Sub-Saharan African countries. In Ethiopia, anaemia poses a very strong public health concern. The purpose of the present study was to examine the key risk factors related to anaemia among children aged 6–24 months (younger age group) and 25–59 months (older age group). We used the 2016 Ethiopian Demographic and Health Survey data, collected from 11 023 mothers with under five children. Ordered logistic regression modelling was used for assessing risk factors of childhood anaemia. The results suggest that the prevalence of anaemia was 72 % in the younger and 49 % in the older age groups. The risk factors for anaemia in the younger age group were morbidity (odds ratio (OR) 1⋅77; CI 1⋅21, 2⋅60), having no piped water source (OR 1⋅76; CI 1⋅07, 3⋅01) and no toilet facility (OR 1⋅60; CI 1⋅07, 2⋅38). The key risk factors for anaemia in the older age group were no micronutrient intake (OR 1⋅69; CI 1⋅23, 2⋅31), having a young mother (15–24 years old) (OR 1⋅35; CI 0⋅84, 1⋅91) and a non-working mother (OR 1⋅50; CI 1⋅15, 1⋅96). Anaemia also varied by region, place of residence and economic factors. Multiple factors contributed to the high prevalence of anaemia. Given the structural problem that the country has intervention strategies should consider the unique characteristics of regions and rural residences where the prevalence of anaemia is above the national average.
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Mekete K, Ower A, Dunn J, Sime H, Tadesse G, Abate E, Nigussu N, Seife F, McNaughton E, Anderson RM, Phillips AE. The Geshiyaro Project: a study protocol for developing a scalable model of interventions for moving towards the interruption of the transmission of soil-transmitted helminths and schistosome infections in the Wolaita zone of Ethiopia. Parasit Vectors 2019; 12:503. [PMID: 31665080 PMCID: PMC6820996 DOI: 10.1186/s13071-019-3757-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/22/2019] [Indexed: 12/21/2022] Open
Abstract
Background National deworming programmes rely almost exclusively on mass drug administration (MDA) to children to control morbidity caused by these parasitic infections. The provision of other interventions, consisting of preventive chemotherapy at high population level coverage together with water, sanitation and hygiene (WaSH) and changes in risk behaviour, should enable sustainable control of soil-transmitted helminths (STH) and schistosomiasis and ultimately interrupt transmission. Methods/Design Two interventions will be implemented by the project: (i) community-wide biannual albendazole and annual praziquantel treatment with a target of 80–90% treatment coverage (“expanded MDA”); and (ii) provision of WaSH with behaviour change communication (BCC), within the Wolaita zone, Ethiopia. The project has three study arms: (i) expanded community-wide MDA, WaSH and BCC; (ii) expanded community-wide MDA only; and (iii) annual school-based MDA (the current National STH/schistosomiasis Control Programme). The impact of these interventions will be evaluated through prevalence mapping at baseline and endline (after four rounds of MDA), combined with annual longitudinal parasitological surveillance in defined cohorts of people to monitor trends in prevalence and reinfection throughout the project. Treatment coverage and individual compliance to treatment will be monitored by employing fingerprint biometric technology and barcoded identification cards at treatment. WaSH utilisation will be evaluated through school and household level observations and annual WaSH assessment survey. Complementary qualitative surveys will explore practices, cultural and social drivers of risk behaviours, uptake of WaSH and treatment, and assessing the impact of the BCC. Discussion The study has the potential to define an ‘End Game’ for STH and schistosomiasis programmes through provision of multiple interventions. Interrupting transmission of these infections would eliminate the need for long-term repeated MDA, lead to sustained health improvements in children and adults, thereby allowing health systems to focus on other disease control priorities.
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Affiliation(s)
| | - Alison Ower
- London Centre for Neglected Tropical Disease Research, Department of Infectious Diseases Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Julia Dunn
- London Centre for Neglected Tropical Disease Research, Department of Infectious Diseases Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Heven Sime
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Ebba Abate
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Emily McNaughton
- London Centre for Neglected Tropical Disease Research, Department of Infectious Diseases Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Roy Malcolm Anderson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Diseases Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Anna Elizabeth Phillips
- London Centre for Neglected Tropical Disease Research, Department of Infectious Diseases Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK.
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Abstract
A central and critical step in the molecular detection of soil-transmitted helminths from environmental sources is the extraction of DNA from the eggs. In this study, we investigated the yield of DNA extracted from known quantities (500, 100, 50, 20, 10 and 5) of Ascaris suum eggs, as well as directly from wastewater and sludge samples containing Ascaris spp. eggs, using six commercial DNA extraction kits. The amount of DNA extracted was quantified with NanoDrop, Qubit and Ct values from quantitative polymerase chain reaction (qPCR) assay using CFX96 Touch™ real-time PCR equipment. The PowerLyzer Ultraclean Microbial DNA isolation kit and PowerSoil DNA isolation kit gave the highest yield of DNA based on the NanoDrop, Qubit and Ct values. However, the qPCR results indicate that in some of the kits, PCR inhibitors may have been carried over to the PCR reaction. DNA extraction kits that incorporate a bead-beating step as well as other mechanical eggshell disruption steps were superior in extracting DNA from Ascaris spp. eggs. Additionally, for the accurate quantification of extracted DNA, the use of Ct values from qPCR and Qubit readings gives better results compared to the NanoDrop readings. For efficient downstream applications, the use of DNA extraction kits with superior inhibitor removal technology is essential, in addition to a high yield of DNA.
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Takeuchi R, Njenga SM, Ichinose Y, Kaneko S, Estrada CA, Kobayashi J. Is there a gap between health education content and practice toward schistosomiasis prevention among schoolchildren along the shores of Lake Victoria in Kenya? PLoS Negl Trop Dis 2019; 13:e0007572. [PMID: 31425499 PMCID: PMC6715249 DOI: 10.1371/journal.pntd.0007572] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 08/29/2019] [Accepted: 06/22/2019] [Indexed: 01/07/2023] Open
Abstract
Despite provision of preventive measures against schistosomiasis such as mass drug administration (MDA), the prevalence of Schistosoma mansoni remains high in communities living near Lake Victoria. This study aimed to analyse the status of schistosomiasis, including its prevalence, health education, knowledge, attitudes, and practices (KAP) among pupils, and water use in schools in Mbita situated along the shores of Lake Victoria. Four primary schools were selected as target schools and pupils in classes six and seven were recruited as study participants. The prevalence of S. mansoni was examined by Kato-Katz method. Simultaneously, a KAP survey toward schistosomiasis was conducted among the pupils. Health education contents were extracted from textbooks. All primary schools in the study site were surveyed regarding how each secured water used for daily school life. The prevalence of S. mansoni was 56% and 36% in 2015 and 2016, respectively. 60–70% of pupils chose a correct answer for the mode of transmission. More than 70% of pupils answered that bathing in Lake Victoria causes Schistosoma infection; however, more than 70% of pupils bathed in Lake Victoria sometimes or every day. According to the science textbook, “avoiding contact with contaminated water” is the way to prevent schistosomiasis; however, 66% of schools asked pupils to bring water from Lake Victoria. The prevalence of S. mansoni among pupils remains high. Schoolchildren are taught to avoid contact with contaminated water but are often asked to fetch water from the lake. From the school health viewpoint, health education that reflects the social and cultural context of the community in the contents and teaching methods are needed. In addition to this, provision of sanitation infrastructure is needed. A comprehensive and innovative approach which harmonises central and local governments and other stakeholders, as well as community is important to prevent schistosomiasis. According to WHO, it is estimated that at least 206 million people required preventive treatment for schistosomiasis in 2016 and of those at least 90% live in Africa. Moreover, school-age children are most affected by this worm. In Kenya, despite preventive measures against schistosomiasis such as mass drug administration (MDA) in primary schools, it remains a major public health problem, especially along the shores of Lake Victoria. Our study revealed that the prevalence of Schistosoma mansoni was high among pupils despite their knowledge about schistosomiasis transmission. This can be attributed to lack of safe water supply and latrines. A comprehensive approach which harmonises central and local governments and other stakeholders, as well as community is needed to prevent schistosomiasis. For example, the combination of health education (in which schools play as focal point) with provision of water infrastructure, encouragement to use and construct toilets in both schools and community/households, snail control, and MDA with monitoring can be employed to control and prevent schistosomiasis. From the school health viewpoint, it is necessary to develop health education contents and teaching methods that reflect the social and cultural context of the community in order to improve their behaviour and change the social norm.
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Affiliation(s)
- Rie Takeuchi
- Kenya Research Station, Institute of Tropical Medicine, Nagasaki University, Nairobi, Kenya
- * E-mail:
| | - Sammy M. Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Yoshio Ichinose
- Kenya Research Station, Institute of Tropical Medicine, Nagasaki University, Nairobi, Kenya
| | - Satoshi Kaneko
- Kenya Research Station, Institute of Tropical Medicine, Nagasaki University, Nairobi, Kenya
- Department of Eco-epidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Crystal A. Estrada
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Okinawa, Japan
| | - Jun Kobayashi
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Okinawa, Japan
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Angelo T, Kinung’hi SM, Buza J, Mwanga JR, Kariuki HC, Wilson S. Community knowledge, perceptions and water contact practices associated with transmission of urinary schistosomiasis in an endemic region: a qualitative cross-sectional study. BMC Public Health 2019; 19:703. [PMID: 31174505 PMCID: PMC6554870 DOI: 10.1186/s12889-019-7041-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 05/23/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In an effort to complement the current chemotherapy based schistosomiasis control interventions in Shinyanga district, community knowledge, perceptions and water contact practices were qualitatively assessed using focus group discussions and semi structured interviews involving 271 participants in one S. haematobium prevalent community of Ikingwamanoti village, Shinyanga district, Northwestern, Tanzania. METHODS In October, 2016 we conducted 29 parent semi structured interviews and 16 focus group discussions with a total of 168 parent informants. Adult participants were conveniently selected from three sub-villages of Butini, Miyu, and Bomani of Ikingwamanoti village, Shinyanga district. In March, 2017, a total of 103 children informants participated in 10 focus group discussions and 20 semi structured interviews, administered to children from standard four, five, six and seven attending Ikingwamanoti Primary School. Note taking and digital recorders were used to collect narrative data for thematic analysis of emergent themes. RESULTS Among participants, 75% parents and 50% children considered urinary schistosomiasis as a low priority health problem. Of the informants, 70% children and 48.3% parents had misconceptions about the cause, modes of transmission and control of schistosomiasis demonstrating gaps in their biomedical knowledge of the disease. Assessment of treatment seeking behavior for urinary schistosomiasis revealed a combination of traditional and modern health care sectors. However, modern medicines were considered effective in the treatment of urinary schistosomiasis. Lack of alternative sources of water for domestic and recreational activities and unhygienic water use habits exposed community members to high risk of acquiring urinary schistosomiasis. CONCLUSION Use of Schistosoma haematobium contaminated water sources for daily domestic and recreational use facilitated contraction of urinary schistosomiasis among community members in Shinyanga district. People's perceptions of urinary schistosomiasis as a less priority health problem promoted persistence of the disease. Future efforts to control urinary schistosomiasis should take into account integrated approaches combining water, sanitation and hygiene, health education, alternative sources of clean and safe water to facilitate behavior change.
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Affiliation(s)
- Teckla Angelo
- Department of Global Health and Bio-Medical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), P. O. Box 447, Arusha, Tanzania
- National Institute for Medical Research (NIMR), Mwanza Centre, P. O. Box 1462, Mwanza, Tanzania
| | - Safari M. Kinung’hi
- National Institute for Medical Research (NIMR), Mwanza Centre, P. O. Box 1462, Mwanza, Tanzania
| | - Jorum Buza
- Department of Global Health and Bio-Medical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), P. O. Box 447, Arusha, Tanzania
| | - Joseph R. Mwanga
- National Institute for Medical Research (NIMR), Mwanza Centre, P. O. Box 1462, Mwanza, Tanzania
| | - Henry Curtis Kariuki
- Kenya Methodist University, School of Medicine and Health Sciences, P. O. Box 267, Meru, Kenya
| | - Shona Wilson
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QP UK
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Kulinkina AV, Kosinski KC, Adjei MN, Osabutey D, Gyamfi BO, Biritwum NK, Bosompem KM, Naumova EN. Contextualizing Schistosoma haematobium transmission in Ghana: Assessment of diagnostic techniques and individual and community water-related risk factors. Acta Trop 2019; 194:195-203. [PMID: 30871989 DOI: 10.1016/j.actatropica.2019.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 02/23/2019] [Accepted: 03/10/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The study assessed associations between Schistosoma haematobium infection (presence of parasite eggs in urine or hematuria) and self-reported metrics (macrohematuria, fetching surface water, or swimming) to evaluate their performance as proxies of infection in presence of regular preventive chemotherapy. It also examined community water characteristics (safe water access, surface water access, and groundwater quality) to provide context for schistosomiasis transmission in different types of communities and propose interventions. METHODS Logistic regression was used to assess the associations between the various measured and self-reported metrics in a sample of 897 primary school children in 30 rural Ghanaian communities. Logistic regression was also used to assess associations between community water characteristics, self-reported water-related behaviors and S. haematobium infection. Communities were subsequently categorized as candidates for three types of interventions: provision of additional safe water sources, provision of groundwater treatment, and health education about water-related disease risk, depending on their water profile. RESULTS Microhematuria presence measured with a reagent strip was a good proxy of eggs in urine at individual (Kendall's τb = 0.88, p < 0.001) and at school-aggregated (Spearman's rs = 0.96, p < 0.001) levels. Self-reported macrohematuria and swimming were significantly associated (p < 0.05) with egg presence, but self-reported fetching was not. Of the community water characteristics, greater surface water access and presence of groundwater quality problems were significantly associated with increased likelihood of fetching, swimming, and S. haematobium infection. Access to improved water sources did not exhibit an association with any of these outcomes. CONCLUSIONS The study illustrates that in presence of regular school-based treatment with praziquantel, microhematuria assessed via reagent strips remains an adequate proxy for S. haematobium infection in primary schoolchildren. Community water profiles, in combination with self-reported water-related behaviors, can help elucidate reasons for some endemic communities continuing to experience ongoing transmission and tailor interventions to these local contexts to achieve sustainable control.
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Affiliation(s)
| | | | | | - Dickson Osabutey
- University of Ghana, Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | - Bernard O Gyamfi
- University College of Agriculture and Environmental Studies, Bunso, Ghana
| | | | - Kwabena M Bosompem
- Community Directed Development Foundation, Accra, Ghana; University of Ghana, Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | - Elena N Naumova
- Tufts University School of Engineering, Medford, MA, USA; Tufts University, Friedman School of Nutrition Science and Policy, Boston, MA, USA
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Agide FD, Garmaroudi G, Sadeghi R, Shakibazadeh E, Yaseri M, Koricha ZB, Tefese TB. Application of Kingdon and Hall Models to Review Environmental Sanitation and Health Promotion Policy in Ethiopia: A Professional Perspective as a Review. Ethiop J Health Sci 2019; 29:277-286. [PMID: 31011276 PMCID: PMC6460447 DOI: 10.4314/ejhs.v29i2.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background In the world, many countries, including Ethiopia, are framing policies to roll back the problem of the sanitation. For this, the Kingdon and Hall models are the two distinct models formed to articulate the policy agenda to the health problem. The Kingdon model includes problem, policy and politics streams whereas the Hall model includes legitimacy, feasibility and support of the health policies. Therefore, this review aims to integrate the two models with diseases prevention and health promotion policies of Ethiopia. Methods We used the existing frameworks of the models as a guiding principle. Then, we applied the frameworks of the two models as an important consideration to interlink policy agenda to a given health problem. We also described the existing scientific literature about the sanitation and health promotion. After thoroughly reviewing, possible policy inputs and country setups were included with a brief discussion by comparing different kinds of literatures. Results The two models are recognized as an opportunity to get an essential sanitation policy. The government settled and has closed links to the new innovation as an emerged discourse. Therefore, the two model streams came together for setting sanitation problem on the policy agenda. The technical feasibility, public acceptability and congruence with existing values were all judged to be favorable. Conclusion The integration of policies within the policy frameworks has very important outputs in various countries. Therefore, the field specialists should figure out the problem of policy integration through policy evaluation researches.
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Affiliation(s)
- Feleke Doyore Agide
- Department of Health Education and Promotion, Tehran University of Medical Sciences, Tehran, Iran.,Department of Public Health, Wachemo University, Hossana, Ethiopia
| | - Gholamreza Garmaroudi
- Department of Health Education and Promotion, Tehran University of Medical sciences, Tehran, Iran
| | - Roya Sadeghi
- Department of Health Education and Promotion, Tehran University of Medical sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, Tehran University of Medical sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Tadesse Bekele Tefese
- Department of Medicinal Chemistry, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
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Weldesenbet H, Worku A, Shumbej T. Prevalence, infection intensity and associated factors of soil transmitted helminths among primary school children in Gurage zone, South Central Ethiopia: a cross-sectional study design. BMC Res Notes 2019; 12:231. [PMID: 30992048 PMCID: PMC6469099 DOI: 10.1186/s13104-019-4254-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 04/03/2019] [Indexed: 12/02/2022] Open
Abstract
Objective The aim of this study was to determine the prevalence of soil transmitted helminthes among primary school children. School based cross-sectional study design was employed. A total of six hundred study subjects were selected by a multistage sampling method. Fresh stool specimens were collected using clean, dry and wide mouthed labeled stool cups. It was processed by Kato-Katz technique. The data were analyzed using SPSS version 20 and p-value < 0.05 was considered statistically significant. Result The overall prevalence of soil transmitted helminthes was 57 (9.5%). Hookworm was the most prevalent helminthes species isolated (4.2%) followed by A. lumbricoide (3%). The prevalence of Taenia species, T. trichiura, H. nana and E. vermicularis were; 1.2%, 0.5%, 0.7% and 0.8% respectively. The prevalence of the Soil transmitted helminthes infection was low and all cases of Soil transmitted infections in this study were with low infection intensity. This might be due to the preventive chemotherapy given to the school children. Electronic supplementary material The online version of this article (10.1186/s13104-019-4254-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Habtamu Weldesenbet
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, P.O. Box 07, Wolkite, Ethiopia.
| | - Abdulsemed Worku
- Department of Medicine, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Teha Shumbej
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, P.O. Box 07, Wolkite, Ethiopia
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Appleby LJ, Tadesse G, Wuletawu Y, Dejene NG, Grimes JET, French MD, Teklu A, Moreda B, Negussu N, Kebede B, Yard E, Gardiner I, Drake LJ. Integrated delivery of school health interventions through the school platform: Investing for the future. PLoS Negl Trop Dis 2019; 13:e0006449. [PMID: 30703087 PMCID: PMC6354954 DOI: 10.1371/journal.pntd.0006449] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
School health and nutrition (SHN) programmes are recognized as a significant contributor to both health and education sector goals. The school system offers an ideal platform from which to deliver basic health interventions that target the most common health conditions affecting school-age children (SAC) in low-income countries, leading to improved participation and learning outcomes. However, governments require evidence to cost, design, and implement these programmes. In Ethiopia, prevalent health conditions affecting SAC's education participation and learning outcomes include infection with soil-transmitted helminths (STHs), hunger, and malnutrition. In recognition of the multiple issues affecting the health and education of SAC, the government has taken a proactive approach, coordinating an integrated SHN programme designed to be implemented in partnership and monitored and financed through a single, integrated mechanism. The programme, known as the Enhanced School Health Initiative (ESHI), integrates three complimentary health interventions: deworming; school feeding; and provision of a water, sanitation, and hygiene (WASH) package in schools, which in delivery aim to maximize the benefits of each of the individual components. Operational research surrounding the ESHI programme includes both qualitative and quantitative analyses. Here, we present an overview of the ESHI programme and its genesis. We also introduce three additional supporting papers that provide in-depth analyses of key findings, including the baseline situational analysis, the costs, and community perceptions of the programme. The findings from ESHI provide initial evidence to develop an understanding of the related costs and synergies of integrating multiple health interventions onto a single platform. The work has translated into strengthened institutional capacity and improved cross-sectoral coordination. The government is now committed to supporting 25 million school children in Ethiopia through SHN. The ESHI model serves as a reference point for other countries looking to scale up targeted SHN interventions.
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Affiliation(s)
- Laura J. Appleby
- Partnership for Child Development, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
- * E-mail: (LJA); (LJD)
| | - Gemechu Tadesse
- Department of Bacterial, Parasitic and Zoonotic Diseases, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yonas Wuletawu
- Department of Bacterial, Parasitic and Zoonotic Diseases, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Nigussie G. Dejene
- Partnership for Child Development, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Jack E. T. Grimes
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Michael D. French
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Askale Teklu
- United Nations World Food Programme, Addis Ababa, Ethiopia
| | | | | | | | - Elodie Yard
- Partnership for Child Development, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Iain Gardiner
- Partnership for Child Development, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Lesley J. Drake
- Partnership for Child Development, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
- * E-mail: (LJA); (LJD)
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Osei FB, Stein A, Ofosu A. Poisson-Gamma Mixture Spatially Varying Coefficient Modeling of Small-Area Intestinal Parasites Infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030339. [PMID: 30691092 PMCID: PMC6388120 DOI: 10.3390/ijerph16030339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/15/2019] [Accepted: 01/18/2019] [Indexed: 06/09/2023]
Abstract
Understanding the spatially varying effects of demographic factors on the spatio-temporal variation of intestinal parasites infections is important for public health intervention and monitoring. This paper presents a hierarchical Bayesian spatially varying coefficient model to evaluate the effects demographic factors on intestinal parasites morbidities in Ghana. The modeling relied on morbidity data collected by the District Health Information Management Systems. We developed Poisson and Poisson-gamma spatially varying coefficient models. We used the demographic factors, unsafe drinking water, unsafe toilet, and unsafe liquid waste disposal as model covariates. The models were fitted using the integrated nested Laplace approximations (INLA). The overall risk of intestinal parasites infection was estimated to be 10.9 per 100 people with a wide spatial variation in the district-specific posterior risk estimates. Substantial spatial variation of increasing multiplicative effects of unsafe drinking water, unsafe toilet, and unsafe liquid waste disposal occurs on the variation of intestinal parasites risk. The structured residual spatial variation widely dominates the unstructured component, suggesting that the unaccounted-for risk factors are spatially continuous in nature. The study concludes that both the spatial distribution of the posterior risk and the associated exceedance probability maps are essential for monitoring and control of intestinal parasites.
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Affiliation(s)
- Frank Badu Osei
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, 7522 NB Enschede, The Netherlands.
| | - Alfred Stein
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, 7522 NB Enschede, The Netherlands.
| | - Anthony Ofosu
- Policy, Planning, Monitoring and Evaluation (PPME)⁻Ghana Health Service; Accra, Ghana.
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Atalabi TE, Adubi TO. The epidemiology and chemotherapeutic approaches to the control of urinary schistosomiasis in school-age children (SAC): a systematic review. BMC Infect Dis 2019; 19:73. [PMID: 30658583 PMCID: PMC6339440 DOI: 10.1186/s12879-018-3647-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 12/21/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Human schistosomiases are acute and chronic infectious diseases of poverty. Currently, epidemiological data of urinary schistosomiasis (US) in school-age children (SAC) and adults are often reported together making it difficult to ascertain the true status of the disease. Based on this premise, we set out to carry out this review. METHOD To achieve this aim, we carried out a computer-aided search of PubMed, Web of Science, Science Direct, African Journals OnLine (AJOL) and the database of World Health Organization. However, the information obtained from these sources was supplemented with additional literatures from Mendeley, Research Gate, and Google. RESULTS The search yielded 183 literatures of which 93 full text research, review and online articles were deemed fit for inclusion. Our key findings showed that: (1) of all World Health Organization (WHO) Regions, Africa is the most endemic zone for US, with Kenya and Senegal recording the highest prevalence and mean intensity respectively; (2) SAC within the range of 5-16 years contribute most significantly to the transmission cycle of US globally; (3) gender is a factor to watch out for, with male often recording the highest prevalence and intensity of infection; (4) contact with open, potentially infested water sources contribute significantly to transmission; (5) parental factors (occupation and education status) predispose SAC to US; (6) economic vis a vis ecological factors play a key role in infection transmission; and (7) in the last decade, a treatment coverage of 45% was never achieved globally for SAC or non-SAC treatment category for urinary schistosomiasis. CONCLUSION In view of the WHO strategic plan to eliminate schistosomiasis by 2020 and the findings from this review, it is obvious that this goal, in the face of realities, might not be achieved. It is imperative that annual control programmes be scaled up marginally, particularly in the African region of WHO. While US-based researches should be sponsored at the grass-root level to unveil hidden endemic foci, adequate facilities for Water, Sanitation, and Hygiene (WASH) should be put in place in all schools globally.
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Affiliation(s)
- Tolulope Ebenezer Atalabi
- Department of Biological Sciences, Federal University, Dutsin-Ma, Km 65, P.M.B. 5001, Dutsin-Ma, Katsina State Nigeria
| | - Taiwo Oluwakemi Adubi
- Department of Biological Sciences and Biotechnology, College of Pure and Applied Sciences, Caleb University, Imota, Lagos State Nigeria
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Nute AW, Endeshaw T, Stewart AEP, Sata E, Bayissasse B, Zerihun M, Gessesse D, Chernet A, Chanyalew M, Tedessse Z, King JD, Emerson PM, Callahan EK, Nash SD. Prevalence of soil-transmitted helminths and Schistosoma mansoni among a population-based sample of school-age children in Amhara region, Ethiopia. Parasit Vectors 2018; 11:431. [PMID: 30041691 PMCID: PMC6056938 DOI: 10.1186/s13071-018-3008-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 07/10/2018] [Indexed: 12/03/2022] Open
Abstract
Background From 2011 to 2015, seven trachoma impact surveys in 150 districts across Amhara, Ethiopia, included in their design a nested study to estimate the zonal prevalence of intestinal parasite infections including soil-transmitted helminths (STH) and Schistosoma mansoni. Methods A multi-stage cluster random sampling approach was used to achieve a population-based sample of children between the ages of 6 and 15 years. Stool samples of approximately 1 g were collected from assenting children, preserved in 10 ml of a sodium acetate-acetic acid-formalin solution, and transported to the Amhara Public Health Research Institute for processing with the ether concentration method and microscopic identification of parasites. Bivariate logistic and negative binomial regression were used to explore associations with parasite prevalence and intensity, respectively. Results A total of 16,955 children were selected within 768 villages covering 150 districts representing all ten zones of the Amhara region. The final sample included 15,455 children of whom 52% were female and 75% reported regularly attending school. The regional prevalence among children of 6 to 15 years of age was 36.4% (95% confidence interval, CI: 34.9–38.0%) for any STH and 6.9% (95% CI: 5.9–8.1%) for S. mansoni. The zonal prevalence of any STH ranged from 12.1 to 58.3%, while S. mansoni ranged from 0.5 to 40.1%. Categories of risk defined by World Health Organization guidelines would indicate that 107 districts (71.3%) warranted preventive chemotherapy (PC) for STH and 57 districts (38.0%) warranted PC for schistosomiasis based solely on S. mansoni. No statistical differences in the prevalence of these parasites were observed among boys and girls, but age and school attendance were both associated with hookworm infection (prevalence odds ratio, POR: 1.02, P = 0.03 per 1 year, and POR: 0.81, P = 0.001, respectively) and age was associated with infection by any STH (POR: 1.02, P = 0.03). Age was also associated with reduced intensity of Ascaris lumbricoides infection (unadjusted rate ratio: 0.96, P = 0.02) and increased intensity of hookworm infection (unadjusted rate ratio: 1.07, P < 0.001). Conclusions These surveys determined that between 2011 and 2015, STH and Schistosoma mansoni were present throughout the region, and accordingly, these results were used to guide PC distribution to school-age children in Amhara. Electronic supplementary material The online version of this article (10.1186/s13071-018-3008-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrew W Nute
- The Carter Center, 453 Freedom Parkway, Atlanta, GA, 30307, USA.
| | | | | | - Eshetu Sata
- The Carter Center, P.O. Box 13373, Addis Ababa, Ethiopia
| | | | - Mulat Zerihun
- The Carter Center, P.O. Box 13373, Addis Ababa, Ethiopia
| | | | | | - Melsew Chanyalew
- Amhara Regional Health Bureau, P.O. Box 495, Bahir Dar, Ethiopia
| | | | - Jonathan D King
- World Health Organization, Avenue Appia 20, 27, Geneva, Switzerland
| | - Paul M Emerson
- International Trachoma Initiative, 330 West Ponce de Leon Ave, Decatur, GA, 30030, USA
| | | | - Scott D Nash
- The Carter Center, 453 Freedom Parkway, Atlanta, GA, 30307, USA
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Melku M, Takele WW, Anlay DZ, Ekubagewargies DT, Getaneh Z, Abebe M, Abebe Z. Male and undernourished children were at high risk of anemia in Ethiopia: a systematic review and meta-analysis. Ital J Pediatr 2018; 44:79. [PMID: 29996879 PMCID: PMC6042228 DOI: 10.1186/s13052-018-0513-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/13/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Anemia is one of the global public health problems affecting more than one-third of the world population. It has been strongly associated with limited psychomotor development; and poor growth and performance in cognitive, social, and emotional function in children. Despite published data revealed that anemia is a public health problem among children in Ethiopia, there is no a pooled national estimate on the prevalence and associated risk factors of anemia. METHODS Published articles until December 31, 2017, were searched using comprehensive search strings through PubMed/Medline, EMBASE, SCOPUS, HINARI, Web of Science, Google Scholar and Google. Reference probing of published articles and hand searching were employed for grey literature. Two groups of review authors independently appraised the studies for eligibility and extracted the data. The quality of articles was assessed using Joana Brigg's institute critical appraisal checklist for prevalence and analytical studies. The pooled estimates were determined using random effect model. Heterogeneity between the included studies was assessed using the I2 statistics. Subgroup analysis was employed in the evidence of heterogeneity. Publication bias was assessed by visual inspection of the funnel plot and Egger's regression test statistic. RESULTS Of the total 871 articles retrieved, 34 articles which involved 61,748 children were eligible for meta-analysis. The overall pooled prevalence of anemia using random effect model was 31.14% (95% CI: 24.62, 37.66%). In subgroup analysis, the pooled prevalence of anemia was higher among preschool-aged children (44.17%; 95% CI: 37.19, 51.15%) than school-aged children (22.19%; 95% CI: 17.54, 26.83%). Furthermore, the odds of anemia was higher among children who were male (OR = 1.11; 95% CI: 1.03, 1.19), stunted (OR = 1.95; 95% CI: 1.52, 2.51), and wasted (OR = 2.05; 95% CI: 1.36, 3.10). CONCLUSION The pooled prevalence of anemia among children was high, indicating that it had been continuing to be a public health problem. Therefore, there is a need to design a comprehensive prevention and control strategies to reduce its burden.
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Affiliation(s)
- Mulugeta Melku
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Wubet Worku Takele
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Degefaye Zelalem Anlay
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Zegeye Getaneh
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Molla Abebe
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Zegeye Abebe
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Adriko M, Tinkitina B, Arinaitwe M, Kabatereine NB, Nanyunja M, M. Tukahebwa E. Impact of a national deworming campaign on the prevalence of soil-transmitted helminthiasis in Uganda (2004-2016): Implications for national control programs. PLoS Negl Trop Dis 2018; 12:e0006520. [PMID: 29975696 PMCID: PMC6135520 DOI: 10.1371/journal.pntd.0006520] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 09/12/2018] [Accepted: 05/11/2018] [Indexed: 12/11/2022] Open
Abstract
Background Soil-transmitted Helminths and Anemia potentially reduce and retard cognitive and physical growth in school-age children with great implications for national control programs in Africa. After 13 years of deworming and limited health education campaigns, a study was undertaken to evaluate the impact of deworming interventions on the prevalence and intensity of soil-transmitted helminthic infections in school-age children in Uganda. Methodology A cross-sectional study was carried out in six regions of Uganda, where two districts were randomly selected per region based on the ecological zones in the country. Included in the study were the districts; Mpigi and Nakasongola from the Central; Nakapiripirit and Kotido from Karamoja; Arua and Yumbe from West Nile; Gulu and Alebtong from the North; Kaliro and Mbale from the East; Hoima and Bundibugyo in the West. Five schools were randomly selected from each district and in each school 50 children aged 6–14 years were randomly selected. Stool samples were taken each child and examined for the presence of helminthic infections. A short pretested questionnaire was administered to each participant to obtain their knowledge, attitude, and practice relating to STH infections, their control. General observations were made on environmental sanitation in the schools. The location of each school was geo-referenced using a GPS machine (Garmin®GPSMAP62, Garmin Ltd, Southampton, UK). Results In total, 4,285 children were assessed including 719(16.82%) from central region, 718(16.80%) from eastern region, 719 (16.82%) from northern region, 689 (18.82%) from Karamoja region, 717(16.77%) from West Nile region and 723(16.91%) from western region. The average age of the children was 12.6 years with a standard deviation, SD 1.8 years and the minimum age was 6 years and upper age limit of 12 years. The percentage of boys (50.1%) and girls (49.9%) was comparable. 8.8% (95% CI; 8.0–9.7) were infected with at least any one STH species. Hookworm was the most prevalent (7.7%; 95% CI; 6.9–8.5) followed by whipworms (Trichuris trichiura) (1.3%; 95% CI; 1.0–1.7) and roundworms (Ascaris lumbricoides) (0.5%; 95% CI; 0.3–0.7). Some children had Schistosoma mansoni, 13.0% (95% CI; 12.0–14.0). All the children knew what soil transmitted helminths were (62.8%, 95% CI: 61.3–64.2) and most common knowledge of information were from; home (39%, 95% CI: 37.1–40.8), media (radio& newspaper)(11%, 95% CI: 9.8–12.2), school(65.7%, 95% CI: 63.9–67.5) and friends(11.5%, 95% CI: 10.3–12.7). Majority were aware of how one gets infected with soil transmitted helminths through; eating contaminated food (77.5%, 95% CI: 76.0–79.1), walking barefoot (59.6%, 95% CI: 57.8–61.5), drinking contaminated water (52.9%, 95% CI: 51.0–54.8), playing in dirty places (21.8%, 95% CI: 20.2–23.3) and dirty hands (2.3%, 95% CI: 1.7–2.9). Conclusion Semi-annual deworming campaigns have proved effective in significantly reducing helminthic infections in most of the districts in Uganda. Regular evaluations are vital to assess impact of the interventions and guide programme implementation. Our data shows that the prevalence of infection has been reduced to a level where STH morbidity is no longer of public health importance in most districts surveyed. Soil-transmitted Helminths potentially reduce physical growth and retard cognitive development in school-age children (SAC) with great implications for national control programs in Africa. In Uganda, baseline investigations between 1998 and 2002, indicated STH prevalence was over 60.0% in most districts, the commonest worms infections were Hookworms, Ascaris and Trichuris. Twice a year national deworming campaign was initiated in 2003 targeting aged 1–14 years. Over ten years of deworming campaigns, has reduced the overall STH prevalence to 8.8% in 2016. The findings suggest routine deworming campaigns reduce STH exposure and infections. Periodic program evaluations are key to determining the progress made in order to achieve the elimination targets by 2020.
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Affiliation(s)
- Moses Adriko
- Uganda Institute of Allied Health & Management Science (UIAHMS), School of Medical Entomology and Parasitology, Kampala, Uganda
- Vector Control Division, Ministry of Health, Kampala, Uganda
| | | | - Moses Arinaitwe
- Uganda Institute of Allied Health & Management Science (UIAHMS), School of Medical Entomology and Parasitology, Kampala, Uganda
| | - Narcis B. Kabatereine
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, Norfolk Place, London, United Kingdom
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Appiah-Brempong E, Harris MJ, Newton S, Gulis G. Examining school-based hygiene facilities: a quantitative assessment in a Ghanaian municipality. BMC Public Health 2018; 18:581. [PMID: 29720144 PMCID: PMC5930960 DOI: 10.1186/s12889-018-5491-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 04/20/2018] [Indexed: 11/12/2022] Open
Abstract
Background The crucial role of adequate water, sanitation and hygiene (WASH) facilities in influencing children’s handwashing behaviour is widely reported. Report from UNICEF indicates a dearth of adequate data on WASH facilities in schools, especially in the developing world. This study sought to contribute to building the evidence-base on school hygiene facilities in Ghana. The study further explored for possible associations and differences between key variables within the context of school water, sanitation and hygiene. Methods Data was collected from 37 junior high schools using an observational checklist. Methods of data analysis included a Scalogram model, Fisher’s exact test, and a Student’s t-test. Results Results of the study showed a facility deficiency in many schools: 33% of schools had students washing their hands in a shared receptacle (bowl), 24% had students using a single cotton towel to dry hands after handwashing, and only 16% of schools had a functional water facility. Furthermore, results of a proportion test indicated that 83% of schools which had functional water facilities also had functional handwashing stations. On the other hand, only 3% of schools which had functional water facilities also had a functional handwashing stations. A test of difference in the proportions of the two sets of schools showed a statistically significant difference (p < 0.001). In addition, 40% of schools which had financial provisions for water supply also had functional handwashing stations. On the other hand, only 7% of schools which had financial provisions for water supply also had functional handwashing stations. There was a statistically significant difference in the proportions of the two sets of schools (p = 0.02). Conclusion We conclude that it is essential to have a financial provision for water supply in schools as this can potentially influence the existence of a handwashing station in a school. An intervention by government, educational authorities and civil society organisations towards enabling schools in low resource areas to have a sustainable budgetary allocation for WASH facilities would be timely.
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Affiliation(s)
- Emmanuel Appiah-Brempong
- Department of Health Promotion and Education, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
| | - Muriel J Harris
- Department of Health Promotion and Behavioral Sciences, University of Louisville, Louisville, USA
| | - Samuel Newton
- Department of Global and International Health, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Gabriel Gulis
- Unit for Health Promotion Research, University of Southern Denmark (SDU), Esbjerg, Denmark
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Braun L, Grimes JET, Templeton MR. The effectiveness of water treatment processes against schistosome cercariae: A systematic review. PLoS Negl Trop Dis 2018; 12:e0006364. [PMID: 29608589 PMCID: PMC5903662 DOI: 10.1371/journal.pntd.0006364] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 04/17/2018] [Accepted: 03/05/2018] [Indexed: 01/16/2023] Open
Abstract
Background Schistosomiasis is one of the most disabling neglected tropical diseases, ranking second in terms of years lived with disability. While treatment with the drug praziquantel can have immediate beneficial effects, reinfection can occur rapidly if people are in contact with cercaria-infested water. Water treatment for schistosomiasis control seeks to eliminate viable cercariae from water, thereby providing safe alternative water supplies for recreational and domestic activities including laundry and bathing. This provision may reduce contact with infested water, which is crucial for reducing reinfection following chemotherapy and cutting schistosome transmission. Methodology A qualitative systematic review was carried out to summarize the existing knowledge on the effectiveness of water treatment in removing or inactivating human schistosome cercariae. Four online databases were searched. Studies were screened and categorized into five water treatment processes: storage, heating, chlorination, filtration, and ultraviolet (UV) disinfection. Conclusions All five water treatment methods can remove or inactivate cercariae in water, and hence produce cercaria-free water. However, reliable design guidelines for treating water do not exist as there are insufficient data. Overall, the review found that cercariae are inactivated when storing water for 10–72 hours (depending on temperature), or with chlorination values of 3–30 mg-min/l. UV fluences between 3–60 mJ/cm2 may significantly damage or kill cercariae, and sand filters with 0.18–0.35 mm grain size have been shown to remove cercariae. This systematic review identified 67 studies about water treatment and schistosomiasis published in the past 106 years. It highlights the many factors that influence the results of water treatment experiments, which include different water quality conditions and methods for measuring key parameters. Variation in these factors limit comparability, and therefore currently available information is insufficient for providing complete water treatment design recommendations. Schistosomiasis control currently focuses on preventive chemotherapy (PC) with praziquantel, which is effective, safe, and inexpensive. However, this treatment does not prevent subsequent reinfection. As schistosomiasis control targets become more ambitious and move towards elimination, interest is increasing in the potentially complementary roles of water, sanitation, and hygiene (WASH) interventions which may disrupt transmission of the parasite, thereby slowing reinfection following treatment. Water treatment for schistosomiasis control seeks to eliminate viable schistosome cercariae from water. We carried out a systematic review to summarize the existing knowledge on the effectiveness of water treatment for the removal or inactivation of cercariae, by processes including chlorination, filtration, UV disinfection, heating, and water storage. This is the first review of its kind and provides a concise summary of what is known to-date regarding water treatment against cercariae of different Schistosoma species. The review also identifies gaps in knowledge and provides crucial and timely guidance for the control and elimination of schistosomiasis, by highlighting the requirements for designing effective and sustainable water infrastructure for schistosomiasis-endemic regions.
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Affiliation(s)
- Laura Braun
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London, United Kingdom
| | - Jack E T Grimes
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London, United Kingdom
| | - Michael R Templeton
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London, United Kingdom
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Chala B, Torben W. An Epidemiological Trend of Urogenital Schistosomiasis in Ethiopia. Front Public Health 2018; 6:60. [PMID: 29556490 PMCID: PMC5844936 DOI: 10.3389/fpubh.2018.00060] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/15/2018] [Indexed: 11/18/2022] Open
Abstract
Schistosomiasis is a major public health problem in Ethiopia. Currently, the prevalence of the disease can possibly be heightened due to man-made ecological transformations particularly related to the recent development programs involving irrigation and construction of dams. The expansion of some of the water resource development projects has been cited enhancing the upsurge of urogenital schistosomiasis mainly in the lower altitude areas of the country. In connection to the extensive initiation of development projects in low altitude areas of the country, simultaneous and adequate attentions have never been given to address a pre-assessment of health impacts of the development programs prior to launching the projects. Helpful appraisals focusing on evaluation of epidemiology of urogenital schistosomiasis in Ethiopia have not been explored. Therefore, the current review attempts to trace an overall picture of the epidemiological status of urogenital schistosomiasis in the country; the past and existing trends of urogenital schistosomiasis surveys and control programs of the country are reviewed. Essential recommendations are highlighted for possible inputs in future control design strategies of national control program of schistosomiasis.
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Affiliation(s)
- Bayissa Chala
- Department of Applied Biology, School of Applied Natural Science, Adama Science and Technology University, Adama, Ethiopia.,Department of Parasitology and Tropical Medicine, College of Medicine, Seoul National University, Seoul, South Korea
| | - Workineh Torben
- Division of Pathology, Tulane National Primate Research Center, Covington, LA, United States
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Al-Mendalawi MD. Prevalence of intestinal helminthic infections and malnutrition among schoolchildren of the Zegie Peninsula, northwestern Ethiopia. J Infect Public Health 2018; 11:150. [PMID: 28797538 DOI: 10.1016/j.jiph.2017.07.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 07/09/2017] [Indexed: 10/19/2022] Open
Affiliation(s)
- Mahmood D Al-Mendalawi
- Department of Paediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad, Iraq.
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Rivero MR, De Angelo C, Nuñez P, Salas M, Motta CE, Chiaretta A, Salomón OD, Liang S. Environmental and socio-demographic individual, family and neighborhood factors associated with children intestinal parasitoses at Iguazú, in the subtropical northern border of Argentina. PLoS Negl Trop Dis 2017; 11:e0006098. [PMID: 29155829 PMCID: PMC5714390 DOI: 10.1371/journal.pntd.0006098] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 12/04/2017] [Accepted: 11/05/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Intestinal parasitoses are a major concern for public health, especially in children from middle and low-income populations of tropical and subtropical areas. We examined the presence and co-infection of parasites in humans as well as parasitic environmental contamination in Puerto Iguazú, Argentina. We explored the environmental and socio-demographic characteristics of the persistence of parasites in children and their environment. METHODOLOGY/PRINCIPAL FINDINGS This cross-section survey was conducted among children population comprised into the area of the public health care centers of Iguazú during June 2013 to May 2016. Copro-parasitological status of 483 asymptomatic children was assessed. Simultaneously, a design-based sampling of 744 soil samples and 530 dog feces was used for characterize the environmental contamination. The 71.5% of these sites were contaminated. Sixteen genera were detected in the environment being hookworms (62.0%) the main pathogens group detected followed by Toxocara spp (16.3%), Trichuris spp (15.2%) and Giardia (6.5%). Total children prevalence raised 58.8%, detecting twelve genera of parasite with Giardia intestinalis as the most prevalent pathogen (29.0%) followed by Enterobius vermicularis (23.0%), Hymenolepis nana (12.4%) and hookworms (4.4%). Through questionnaires and census data, we characterized the socio-demographics conditions at an individual, family and neighborhood levels. A multi-level analysis including environmental contamination data showed that the ´presence of parasites´ was mostly determined by individual (e.g. age, playing habits, previous treatment) and household level (e.g. UBN, WASH, mother's literacy) determinants. Remarkably, to define the level of 'parasite co-infection', besides individual and household characteristics, environmental factors at a neighborhood level were important. CONCLUSION/SIGNIFICANCE Our work represents the major survey of intestinal parasites in human and environmental samples developed in the region. High prevalence was detected in the children population as well as in their environment. This work shows the importance of considering and promoting multi-level actions over the identified determinants to face this public health problem from integrative approaches.
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Affiliation(s)
- Maria Romina Rivero
- Instituto Nacional de Medicina Tropical, INMeT. Ministerio de Salud de la Nación. Puerto Iguazú, Misiones. Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET. Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Carlos De Angelo
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET. Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Instituto de Biología Subtropical (IBS, UNaM-CONICET). Puerto Iguazú, Misiones. Argentina
- Assoc. Civil Centro de Investigaciones del Bosque Atlántico (CeIBA). Puerto Iguazú, Misiones. Argentina
| | - Pablo Nuñez
- Instituto Nacional de Medicina Tropical, INMeT. Ministerio de Salud de la Nación. Puerto Iguazú, Misiones. Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET. Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Martín Salas
- Instituto Nacional de Medicina Tropical, INMeT. Ministerio de Salud de la Nación. Puerto Iguazú, Misiones. Argentina
| | - Carlos E. Motta
- Departamento de Patología Animal, Facultad de Agronomía y Veterinaria, Universidad Nacional de Rio Cuarto. Rio Cuarto, Córdoba. Argentina
| | - Alicia Chiaretta
- Departamento de Patología Animal, Facultad de Agronomía y Veterinaria, Universidad Nacional de Rio Cuarto. Rio Cuarto, Córdoba. Argentina
| | - Oscar D. Salomón
- Instituto Nacional de Medicina Tropical, INMeT. Ministerio de Salud de la Nación. Puerto Iguazú, Misiones. Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET. Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Song Liang
- Department of Environmental and Global Health, University of Florida, Gainesville, Florida, United States of America
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
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Campbell SJ, Biritwum NK, Woods G, Velleman Y, Fleming F, Stothard JR. Tailoring Water, Sanitation, and Hygiene (WASH) Targets for Soil-Transmitted Helminthiasis and Schistosomiasis Control. Trends Parasitol 2017; 34:53-63. [PMID: 29055522 DOI: 10.1016/j.pt.2017.09.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 09/22/2017] [Accepted: 09/25/2017] [Indexed: 12/17/2022]
Abstract
The World Health Organization's (WHO) 2015-2020 Global Strategy on water, sanitation, and hygiene (WASH) and neglected tropical diseases (NTDs) encourages integration, whilst maintaining existing structured NTD investments, and acceleration towards Sustainable Development Goal (SDG) targets. Accordingly, SDG-associated and WASH-NTD indicators have been developed, commencing important intersectoral dialogue, alongside opportunities for future disease-specific refinements. The rationale for soil-transmitted helminthiasis (STH)- and schistosomiasis-specific WASH considerations, and a traffic-light figure, are presented here to indicate where current international definitions may, or may not, suffice. Certain unique aspects in control dynamics and parasitic lifecycles, however, necessitate additional implementation research with more appropriate measurement indicators developed to record programmatic interventions and to define strategic priorities more effectively.
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Affiliation(s)
- Suzy J Campbell
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK; Present address: Deworm the World Initiative, Evidence Action, Brisbane, 4020, Australia.
| | - Nana-Kwadwo Biritwum
- National Neglected Tropical Disease Control Programme, Ghana Health Services, Accra, Ghana
| | | | | | - Fiona Fleming
- Schistosomiasis Control Initiative, Imperial College, London, W2 1PG, UK
| | - J Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
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41
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Grimes JET, Tadesse G, Gardiner IA, Yard E, Wuletaw Y, Templeton MR, Harrison WE, Drake LJ. Sanitation, hookworm, anemia, stunting, and wasting in primary school children in southern Ethiopia: Baseline results from a study in 30 schools. PLoS Negl Trop Dis 2017; 11:e0005948. [PMID: 28991894 PMCID: PMC5633169 DOI: 10.1371/journal.pntd.0005948] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 09/09/2017] [Indexed: 11/18/2022] Open
Abstract
Background Inadequate nutrition; neglected topical diseases; and insufficient water, sanitation, and hygiene (WASH) are interrelated problems in schools in low-income countries, but are not routinely tackled together. A recent three-year longitudinal study investigated integrated school health and nutrition approaches in 30 government primary schools in southern Ethiopia. Here, we report on baseline associations between sanitation, hookworm infection, anemia, stunting, and wasting. Methods In each school, the Schistosoma mansoni, S. haematobium, and soil-transmitted helminth infection intensities; blood hemoglobin concentrations; heights; and weights of approximately 125 students were assessed. Of these 125 students, approximately 20 were randomly selected for student WASH surveys. Of these 20, approximately 15 were randomly selected for household sanitation observations. School WASH was also assessed through a combination of observations and questions to the headteacher. Mixed-effects logistic regression was used to compare household sanitation with hookworm infection (the other parasites being much less prevalent); and hookworm infection with anemia, stunting, and wasting. Findings Blood, stool, and urine samples were provided by 3,729 children, and student WASH and household WASH surveys were conducted with 596 and 448 of these students, respectively. Hookworm, Ascaris lumbricoides, Trichuris trichiura, and S. mansoni infections had prevalences of 18%, 4.8%, 0.6%, and 0.3%, respectively, and no S. haematobium infections were found. Anemia, stunting, and wasting had prevalences of 23%, 28%, and 14%, respectively. No statistically significant associations were found between latrine absence or evidence of open defecation at home, and hookworm infection (adjusted odds ratio, OR = 1.28, 95% confidence interval, CI: 0.476–3.44; and adjusted OR = 1.21, 95% CI: 0.468–3.12; respectively); or between hookworm infection and anemia, stunting, or wasting (adjusted OR = 1.24, 95% CI: 0.988–1.57; adjusted OR = 0.992, 95% CI: 0.789–1.25; and adjusted OR = 0.969, 95% CI: 0.722–1.30; respectively). Conclusions In this setting, no statistically significant associations were found between sanitation and hookworm; or between hookworm and anemia, stunting, or wasting. More evidence on best practices for integrated school health interventions will be gathered from the follow-up surveys in this study. It is thought that inadequate sanitation may exacerbate hookworm transmission, and that hookworm infection may give rise to health problems including anemia, stunting, and wasting. Integrating monitoring of, and interventions against, these problems may yield significant cost savings. Such integrated interventions should be guided by both evidence of the relationships between the various health problems, and examples of optimally effective integration. Here, we present baseline findings from a three-year longitudinal study investigating combined school feeding; school water, sanitation, and hygiene (WASH); and deworming interventions in 30 primary schools in southern Ethiopia. In particular, we compare household sanitation, hookworm infection, and anemia, stunting, and wasting, in the schoolchildren. None of these associations were found to be statistically significant (although hookworm infection was associated with borderline statistically significantly higher odds of anemia; P = 0.06). The lack of significant associations may be due to the low intensities of the hookworm infections in this setting, poor conditions of latrines reducing their impact on hookworm transmission, and other factors such as malaria and inadequate diet causing anemia, stunting, and wasting.
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Affiliation(s)
- Jack E. T. Grimes
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London, United Kingdom
- * E-mail:
| | | | - Iain A. Gardiner
- Partnership for Child Development, Department of Infectious Disease Epidemiology, St Mary’s Campus, Imperial College London, London, United Kingdom
| | - Elodie Yard
- Partnership for Child Development, Department of Infectious Disease Epidemiology, St Mary’s Campus, Imperial College London, London, United Kingdom
| | - Yonas Wuletaw
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Michael R. Templeton
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London, United Kingdom
| | - Wendy E. Harrison
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, St Mary’s Campus, Imperial College London, London, United Kingdom
| | - Lesley J. Drake
- Partnership for Child Development, Department of Infectious Disease Epidemiology, St Mary’s Campus, Imperial College London, London, United Kingdom
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42
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A´sbjo¨rnsdo´ttir KH, Means AR, Werkman M, Walson JL. Prospects for elimination of soil-transmitted helminths. Curr Opin Infect Dis 2017; 30:482-488. [PMID: 28700363 PMCID: PMC7680933 DOI: 10.1097/qco.0000000000000395] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW Soil-transmitted helminths (STH) are endemic in 120 countries and are associated with substantial morbidity and loss of economic productivity. Although current WHO guidelines focus on morbidity control through mass drug administration (MDA), there is global interest in whether a strategy targeting disease elimination might be feasible in some settings. This review summarizes the prospects for switching from control to an elimination strategy. RECENT FINDINGS STH control efforts have reduced the intensity of infections in targeted populations with associated reductions in morbidity. However, adults are not frequently targeted and remain important reservoirs for reinfection of treated children. Recent modeling suggests that transmission interruption may be possible through expanded community-wide delivery of MDA, the feasibility of which has been demonstrated by other programs. However, these models suggest that high levels of coverage and compliance must be achieved. Potential challenges include the risk of prematurely dismantling STH programs and the potential increased risk of antihelminthic resistance. SUMMARY Elimination of STH may offer an opportunity to eliminate substantial STH-related morbidity while reducing resource needs of neglected tropical disease programs. Evidence from large community trials is needed to determine the feasibility of interrupting the transmission of STH in some geographic settings.
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Affiliation(s)
- Kristjana H. A´sbjo¨rnsdo´ttir
- DeWorm3, The Natural History Museum, London, UK
- Department of Global Health, University of Washington, Seattle, Washington, USA and
| | - Arianna R. Means
- DeWorm3, The Natural History Museum, London, UK
- Department of Global Health, University of Washington, Seattle, Washington, USA and
| | - Marleen Werkman
- DeWorm3, The Natural History Museum, London, UK
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research (LCNTDR), St. Mary’s Campus, Imperial College London, London, UK
| | - Judd L. Walson
- DeWorm3, The Natural History Museum, London, UK
- Department of Global Health, University of Washington, Seattle, Washington, USA and
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43
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Pipiková J, Papajová I, Šoltys J, Schusterová I, Kočišová D, Toháthyová A. Segregated settlements present an increased risk for the parasite infections spread in Northeastern Slovakia. Helminthologia 2017. [DOI: 10.1515/helm-2017-0026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Summary
The occurrence of parasitic infections among the children, dogs and its association with soil contamination in two villages with different hygiene level standards were analysed. Infections were present in both examined localities, but in the village with higher living standard, a better personal and communal hygiene level and better dogs care a lower occurrence of parasitic germs in soil was detected. High prevalence of protozoa and helminths was observed not only within canine population but also in children throughout the year in the village with lower hygiene and socio-economic standard. We have identified up to 12 taxa of parasites in 127 collected dogs’ excrements and mean prevalence was 71.65 %. The most frequent were eggs of family Ancylostomatidae and Ascaris spp., followed by Toxocara canis, Toxascaris leonina, Giardia duodenalis cysts, Isospora spp. oocysts, eggs of Capillaria aerophila, Trichuris vulpis, Taenia type eggs, Dipylidium caninum, oocysts of Sarcocystis spp. and larvae of Angiostrongylus vasorum. The soil samples collected near dwellings were highly contaminated. Two thirds of samples contained eggs for the most part of family Ancylostomatidae as well as genera Ascaris and Toxocara. Among the kids population helminth ova were present in 53.17 % of stool samples, where the eggs of Ascaris lumbricoides, Trichuris trichiura, Enterobius vermicularis, Hymenolepis diminuta and cysts of G. duodenalis were the most frequent. In contrast, parasitic diseases were not seen in children population living in the locality with common hygiene standard.
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Affiliation(s)
- J. Pipiková
- Institute of Parasitology of the Slovak Academy of Sciences , Košice , Slovak Republic
| | - I. Papajová
- Institute of Parasitology of the Slovak Academy of Sciences , Košice , Slovak Republic
| | - J. Šoltys
- Institute of Parasitology of the Slovak Academy of Sciences , Košice , Slovak Republic
| | - I. Schusterová
- Department of Paediatrics and Adolescent Medicine, Faculty of Medicine , Pavol Jozef Šafárik University , Košice , Slovak Republic
| | - D. Kočišová
- Department of Paediatrics and Adolescent Medicine, Faculty of Medicine , Pavol Jozef Šafárik University , Košice , Slovak Republic
| | - A. Toháthyová
- Department of Paediatrics and Adolescent Medicine, Faculty of Medicine , Pavol Jozef Šafárik University , Košice , Slovak Republic
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44
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Lo NC, Addiss DG, Hotez PJ, King CH, Stothard JR, Evans DS, Colley DG, Lin W, Coulibaly JT, Bustinduy AL, Raso G, Bendavid E, Bogoch II, Fenwick A, Savioli L, Molyneux D, Utzinger J, Andrews JR. A call to strengthen the global strategy against schistosomiasis and soil-transmitted helminthiasis: the time is now. THE LANCET. INFECTIOUS DISEASES 2016; 17:e64-e69. [PMID: 27914852 DOI: 10.1016/s1473-3099(16)30535-7] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 11/17/2016] [Accepted: 11/22/2016] [Indexed: 01/01/2023]
Abstract
In 2001, the World Health Assembly (WHA) passed the landmark WHA 54.19 resolution for global scale-up of mass administration of anthelmintic drugs for morbidity control of schistosomiasis and soil-transmitted helminthiasis, which affect more than 1·5 billion of the world's poorest people. Since then, more than a decade of research and experience has yielded crucial knowledge on the control and elimination of these helminthiases. However, the global strategy has remained largely unchanged since the original 2001 WHA resolution and associated WHO guidelines on preventive chemotherapy. In this Personal View, we highlight recent advances that, taken together, support a call to revise the global strategy and guidelines for preventive chemotherapy and complementary interventions against schistosomiasis and soil-transmitted helminthiasis. These advances include the development of guidance that is specific to goals of morbidity control and elimination of transmission. We quantify the result of forgoing this opportunity by computing the yearly disease burden, mortality, and lost economic productivity associated with maintaining the status quo. Without change, we estimate that the population of sub-Saharan Africa will probably lose 2·3 million disability-adjusted life-years and US$3·5 billion of economic productivity every year, which is comparable to recent acute epidemics, including the 2014 Ebola and 2015 Zika epidemics. We propose that the time is now to strengthen the global strategy to address the substantial disease burden of schistosomiasis and soil-transmitted helminthiasis.
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Affiliation(s)
- Nathan C Lo
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA; Division of Epidemiology, Stanford University School of Medicine, Stanford, CA, USA.
| | - David G Addiss
- Children Without Worms, Task Force for Global Health, Decatur, GA, USA
| | - Peter J Hotez
- Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine at Baylor College of Medicine, Houston, TX, USA; Department of Biology, Baylor University, Waco, TX, USA; James A Baker III Institute for Public Policy, Rice University, Houston, TX, USA
| | - Charles H King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, USA
| | - J Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Darin S Evans
- United States Agency for International Development, Global Health, Washington, DC, USA
| | - Daniel G Colley
- Center for Tropical and Emerging Global Diseases and the Department of Microbiology, University of Georgia, Athens, GA, USA
| | - William Lin
- Global Public Health, Johnson & Johnson, New Brunswick, NJ, USA
| | - Jean T Coulibaly
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Amaya L Bustinduy
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Giovanna Raso
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Eran Bendavid
- Division of General Medical Disciplines, Stanford University, Stanford, CA, USA; Center for Health Policy and the Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA
| | - Isaac I Bogoch
- Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of Internal Medicine and Infectious Diseases, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Alan Fenwick
- Schistosomiasis Control Initiative, Imperial College London, London, UK
| | - Lorenzo Savioli
- Global Schistosomiasis Alliance, Chavannes de Bogis, Switzerland
| | - David Molyneux
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Kebede SW, Beyene DA, Meshesha AG, Sinishaw MA. Two thirds of hookworm infected children were anemic at the outpatient department in Jimma Health Center, Jimma, Southwest Ethiopia. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2016. [DOI: 10.1016/s2222-1808(16)61111-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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46
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Grimes JET, Templeton MR. School Water, Sanitation, and Hygiene to Reduce the Transmission of Schistosomes and Soil-Transmitted Helminths. Trends Parasitol 2016; 32:661-664. [PMID: 27426250 DOI: 10.1016/j.pt.2016.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 06/17/2016] [Accepted: 06/22/2016] [Indexed: 12/19/2022]
Abstract
The life cycles of schistosomes and soil-transmitted helminths (STHs) suggest that water, sanitation, and hygiene (WASH) might reduce their transmission. However, the level of impact of WASH is likely to vary with the location (in school, at home, or elsewhere), the type of WASH, and the parasite in question.
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Affiliation(s)
- Jack E T Grimes
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London SW7 2AZ, UK.
| | - Michael R Templeton
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London SW7 2AZ, UK
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